Background: Data on patients with type 1 diabetes mellitus (T1DM) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are sparse. This study aimed to investigate the association between SARS-CoV-2 infection and T1DM.
Methods: Data from the Prospective Diabetes Follow-up (DPV) Registry were analyzed for diabetes patients tested for SARS-CoV-2 by polymerase chain reaction (PCR) in Germany, Austria, Switzerland, and Luxembourg during January 2020-June 2021, using Wilcoxon rank-sum and chi-square tests for continuous and dichotomous variables, adjusted for multiple testing.
Results: Data analysis of 1855 pediatric T1DM patients revealed no differences between asymptomatic/symptomatic infected and SARS-CoV-2 negative/positive patients regarding age, new-onset diabetes, diabetes duration, and body mass index. Glycated hemoglobin A1c (HbA1c) and diabetic ketoacidosis (DKA) rate were not elevated in SARS-CoV-2-positive vs. -negative patients. The COVID-19 manifestation index was 37.5% in individuals with known T1DM, but 57.1% in individuals with new-onset diabetes. 68.8% of positively tested patients were managed as outpatients/telemedically. Data analysis of 240 adult T1MD patients revealed no differences between positively and negatively tested patients except lower HbA1c. Of these patients, 83.3% had symptomatic infections; 35.7% of positively tested patients were hospitalized.
Conclusions: Our results indicate low morbidity in SARS-CoV-2-infected pediatric T1DM patients. Most patients with known T1DM and SARS-CoV-2 infections could be managed as outpatients. However, SARS-CoV-2 infection was usually symptomatic if it coincided with new-onset diabetes. In adult patients, symptomatic SARS-CoV-2 infection and hospitalization were associated with age.
背景: 关于1型糖尿病(T1DM)和严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)感染患者的数据很少。本研究旨在探讨SARS-CoV-2感染与T1DM的关系。 方法: 对德国, 奥地利, 瑞士和卢森堡在2020年1月至2021年6月期间进行SARS-CoV-2检测的糖尿病患者的前瞻性糖尿病随访(DPV)登记数据进行分析，采用Wilcoxon秩和检验和卡方检验，对连续变量和二分变量进行多重检验。 结果: 1,855例儿童T1DM患者的数据分析显示，无症状/有症状感染和SARS-CoV-2阴性/阳性患者在年龄, 新发糖尿病, 糖尿病病程和体重指数方面没有差异。SARS-CoV-2阳性与阴性患者糖化血红蛋白(HbA1c)和糖尿病酮症酸中毒(DKA)发生率无明显差异。在已知的T1DM患者中，COVID-19的表现指数为37.5%，而在新发糖尿病患者中为57.1%。68.8%的阳性患者以门诊/远程医疗的形式进行管理。对240例成人T1MD患者的数据分析显示，阳性和阴性患者之间除HbA1c降低外，其他均无差异。83.3%的患者有症状感染，35.7%的阳性患者住院治疗。 结论: SARS-CoV-2感染的儿童T1 DM患者的发病率较低。大多数已知的T1糖尿病和SARS-CoV-2感染的患者可以作为门诊患者进行管理。然而，如果SARS-CoV-2感染与新发糖尿病重合，通常是有症状的。在成人患者中，有症状的SARS-CoV-2感染和住院与年龄有关。.
Keywords: 1型糖尿病; COVID-19; DPV database; SARS-CoV-2; diabetic ketoacidosis; type 1 diabetes mellitus; 严重急性呼吸综合征冠状病毒2型; 前瞻性糖尿病随访数据; 新冠肺炎; 糖尿病酮症酸中毒.
© 2022 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.