Sars-cov-2 Infection Is a Potential Risk of Diabetic Ketoacidosis in Children Diagnosed with Type i Diabetes. An Observational Study

Since the beginning of COVID-19 pandemic, several studies have reported increased type 1 diabetes (T1D) and severe diabetic ketoacidosis (DKA) in children. Recent studies have linked viruses to T1D due to their autoimmune nature. SARS-CoV-2 infection may cause hyperglycemia and DKA. In this study we aimed to evaluate the incidence of DKA in pediatric patients with T1D during the initial COVID-19 pandemic and the years preceding it. The present study is a retrospective observational investigation conducted at Minia University Hospital's Pediatric Intensive Care Unit (PICU). Children diagnosed with T1D who recently had SARS-CoV-2, as validated by laboratory testing with the RT-PCR method, were included in the study. The cases referred to during the period from March 2020 to February 2022, which coincided with the pandemic, were compared with those newly diagnosed with diabetes and presented with DKA from March 2018 to February 2020, the pre-pandemic phase. Comparisons were made on the incidence, frequency, and diagnostic criteria. During the pandemic period, we admitted 212 cases of new‐onset T1D. Of these, 159 (75%) patients had DKA, and 53 (25%) had hyperglycemia. Comparing the pre-pandemic with the pandemic period, we noted that the number of children identified with T1D had risen from 4.99/100,000children per year in pre-pandemic periods to 8.46 /100 000 PY in the pandemic period with an incidence rate ratio (IRR) of 6.25 (95% CI 2.90 to 7.83); p<0.0001. COVID-19 pandemic has caused a rise in the number of children with newly diagnosed diabetes, and more people with newly diagnosed diabetes are now presenting with severe DKA.