COVID-19 Infection Increases Risk of Diabetes Diagnosis in Pediatric Patients

New type 1 diabetes (T1D) diagnoses are more likely to occur among pediatric patients who had a prior COVID-19 infection than in those with other respiratory infections, according to a study published in JAMA Network Open.

Additionally, investigators said that the risk of T1D for those with a prior COVID-19 infection was higher than with other encounters with health systems. According to the study, respiratory infections have previously been associated with the onset of T1D.

Investigators included 314,917 patients with COVID-19 and 776,577 patients with non-COVID-19 respiratory infections. They matched the cohort to include 285,628 patients with COVID-19 and the same number with non-COVID-19 respiratory infections.

At month 6 post-COVID-19 infection, 123 patients received a diagnosis of T1D and only 72 were diagnosed with T1D 6 months post-non-COVID-19 respiratory infection.

At 1-, 3-, and 6-months post-infection, the risk of diagnosis of T1D was greater among those infected with COVID-19 compared with other respiratory infections. The results also applied to subgroups of those aged 0 to 9 years and those aged 10 to 18 years.

Investigators found similar increased risks in pediatric individuals infected with SARS-CoV-2 compared with other control cohorts at 6 months, including fractures and well child visits.

In the study, investigators used data from the TriNetX Analytics Platform, which is a database of deidentified electronic health records (EHRs) of more than 90 million individuals from the Global Collaborative Network, which includes 74 large health care organizations across the United States and 14 countries with various geographic, race, age, income, and insurance backgrounds.

The population included pediatric individuals who were split into 2 cohorts: 1 included those aged 18 years or younger with a SARS-CoV-2 infection between March 2020 and December 2021, and the other included those aged 18 years or younger with other respiratory infections during the same time period.

The cohorts were also subdivided into 2 other groups, including those aged 0 to 9 years and those 10 to 18 years.

The cohorts were matched 1:1 with the nearest-neighbor greedy matching for demographics and the individual’s family history of diabetes.

They also compared the risk of new diagnosis of T1D within 1, 3, and 6 months after the infection was compared between the matching cohorts. Investigators used the TriNetX Analytics Platform to conduct statistical analyses. Investigators used hazard ratios and 95% confidence intervals to compare the rates of diagnosis between the groups and subgroups in the study.

Study limitations include the potential biases of observational studies using EHRs, including the possibility of misclassification of diabetes as either type 1 or type 2.

Additionally, there was a possibility that additional unidentified factors could have contributed to the association. Investigators say that the results should be confirmed in other populations, but these results are an important consideration for risk-benefit discussions for prevention and treatment of COVID-19 among pediatric populations.

Reference

Kendall EK, Olaker VR, Kaelber DC, Xu R, Davis PB. Association of SARS-CoV-2 infection with new-onset type 1 diabetes among pediatric patients from 2020 to 2021. JAMA Netw Open. 2022;5(9):e2233014. doi:10.1001/jamanetworkopen.2022.33014