ESPE Abstracts (2022) 95 P1-435

ESPE2022 Poster Category 1 Diabetes and Insulin (86 abstracts)

Are we sure that the prevalence of SARS-CoV-2 infection is not underestimated? Usefulness of serological antibodies assays in children and adolescents with type 1 diabetes

Barbara Predieri 1,2 , Patrizia Bruzzi 1 , Marisa Meacci 3 , Paola Caccamo 2 , Antonella Di Caprio 2 , Laura Lucaccioni 1 , Simona F. Madeo 1 , Viola Trevisani 2 & Lorenzo Iughetti 1,2

1Department of Medical and Surgical Sciences of the Mother, Children and Adults - Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy; 2Department of Medical and Surgical Sciences for Mothers, Children and Adults - Post-Graduate School of Pediatrics, University of Modena and Reggio Emilia, Modena, Italy; 3Clinical Microbiology Unit, University Hospital Polyclinic, Modena, Italy

Introduction: The true incidence of SARS-CoV-2 infection in children and young people (CYP) is unclear and data are influenced by testing strategies. CYP have so far accounted for 17.5-22% of diagnosed infections. In adults, diabetes was identified as risk factor for severe symptoms and hospitalization with the COVID-19. Eighteen months into the pandemic, studies in CYP with type 1 diabetes (T1D) reported only an increased prevalence of diabetic ketoacidosis (DKA) at T1D onset.

Objectives: To investigate the prevalence and clinical characteristics of SARS-CoV-2 infection in CYP with T1D.

Methods: SARS-CoV-2 infection was defined according to self-reported previous SARS-CoV-2 nasal swab PCR results in 210 CYP followed during 18 months of the pandemic and seroprevalence of antibodies against the SARS-CoV-2 spike protein assessed in 85 CYP (Previous negative nasal swab PCR or never performed) from January to June 2021, before COVID-19 vaccination era. SARS-CoV-2 IgG were assessed using a chemiluminescent immunoassay (CLIA). Data on clinical characteristics as well as glycemic control were collected before (T0) and 3-months after (T1) infection.

Results: SARS-CoV-2 infection was detected in 39 patients (males 61.5%; median age 13.5 and T1D duration 5.49 yrs.) during second and third wave: 26 (66.6%) based on the self-reported nasal swab PCR results and 13 (33.4%) on the SARS-CoV-2 IgG assay. All patients detected by CLIA were asymptomatic. Four patients detected by nasal swab PCR were asymptomatic (15.4%). Other patients reported ≥1 symptoms lasting a median of 5 days and including: fever (46.1%), headache (28.2%), anosmia and/or ageusia (25.6%), nasal congestion (15.4%), and fatigue/myalgia (10.2%). Dry cough, pharyngeal erythema, nausea and/or vomiting, diarrhea, abdominal pain, and arthralgia were less reported (2.56%). None had dyspnea, skin lesion, and MIS-C. Hospitalizations, DKA, and severe hypoglycemic events were not recorded. Glycemic control was not impaired from T0 to T1 (see Table).

Characteristics/Period: T0 T1 p
HbA1c (mmol/mol) 62.4±16.4 (58.5) 60.2±13.6 (57.4) 0.332
TIR (%) 52.3±17.0 (58.5) 55.5±15.4 (56.5) 0.186
TAR (%) 42.1±16.2 (39.0) 40.2±15.1 (40.5) 0.518
TBR (%) 4.64±4.41 (3.00) 4.33±3.48 (3.00) 0.632

Conclusions: We found evidence for increased prevalence of SARS-CoV-2 infection among CYP with T1D using antibodies against the SARS-CoV-2 spike protein assessment. Asymptomatic subjects were 43%. COVID-19 pandemic had no impact on glycemic control and acute complications. Our data suggest that serological assay is useful to diagnose previous SARS-CoV-2 infection in not vaccinated CYP and to reconstruct the disease prevalence.

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

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