Comparative study in type 1 diabetes child and adolescents between COVID-19 pandemic and previous period: clinical presentation and reasons for hospitalization in known diabetes in children and adolescents
DOI:
https://doi.org/10.47196/diab.v59i1.1166Keywords:
childhood diabetes, COVID-19 pandemic, diabetes ketoacidosis, debut, hospitalizationAbstract
Introduction: the pandemic caused by the SARS-CoV-2 virus has been devastating, particularly for vulnerable groups. It is important to know how the COVID-19 pandemic impacted the onset forms of type 1 diabetes (OT1D) and the acute complications of patients with a previous diagnosis of type 1 diabetes (PDT1D).
Objetives: to evaluate the clinical and metabolic characteristics associated with the pediatric patient with OT1D and hospitalization due to acute complications in patients with a PDT1D in the COVID19 pandemic period in the Hospital and compare it to the non-pandemic period.
Materials and methods: retrospective, observational study. Under 19 years old patients with type 1 diabetes (T1D), admitted at Hospital in the pre-pandemic period (from March 2018 to August 2019) and during the pandemic (from March 2020 to August 202) were included.
Results: A total of 231 inpatient diagnosed with T1D were analyzed, 135 in pre-pandemic and 96 in pandemic. The mean age was 10.8±3.9 years, the mean BMI 19±4.7; 57.6% were female. The most frequent hospitalization reason (HR) in pre-pandemic was diabetes ketoacidosis (DKA) episodes in PDT1D with 38.5% of total admissions and drops to 28.1% in pandemic. The most frequent HR in pandemic was OT1D in DKA with 40.6% of the total cases vs. 20.7% in pre-pandemic. When analyzing all the HR by OT1D vs PDT1D an increase in the first in pandemic 57/96 vs 53/135 was demonstrated (OR 2.3 95%CI 1.3-3.8; p=0.003). This remain stable when considering only the DKA: 39/67 OT1D in pandemic vs. 27/79 PDT1D (OR 2.6 95%CI 1.3-5.2; p=0.006).
Conclusions: The pandemic affected the prevalence of DKA in OT1D among pediatric patients. PDT1D patients presented better glycemic control and lower risk of hospitalizations. Efforts should be done to continuously raise awareness about diabetes in children and their families as well as the importance of seeking timely medical guidance.
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