ESPE Abstracts

Objectives: Latvia has experienced significant rise in new-onset type 1 diabetes (T1D) cases in children during COVID-19 pandemic from 2020 to 2022, similarly to other countries. In addition, it was recognized that children during pandemic tended to have more severe initial manifestation than it was before pandemic. There have been several theories and studies so far mostly based on patient division in pre-pandemic and pandemic cases. Our aimwas to analyse, whether initial manifestation of T1D differs between patients with or without previous SARS-CoV-2 exposure.

Materials and Methods: In this cross-sectional study new-onset T1D patients who were hospitalized in Children's Clinical University Hospital, Riga, were included both prospectively since August 2022 and retrospectively from year 2017, using medical records. Patients were divided depending on previous COVID-19 history: research group (exposed to SARS-CoV-2 before T1D) and control group (no COVID-19 history and negative SARS-CoV-2 antibodies). Data about initial T1D manifestation and metabolic status were collected and analysed.

Results: In total, 277 patients were included in this study: 122 (44%) in research group (53.3% boys), 155 (56%) in control group (57.4% boys). Mean age by the time of diagnosis in groups were 9.7 (±4.5) and 10.0 (±4.6) years accordingly with significantly lower incidence among 1-4 years olds in research group. Duration of diabetes symptoms before hospitalization was insignificantly longer in research group with median 19 (7.0-30.0) days versus 14 days (7.0-30.0) in control group. Symptoms with significantly higher prevalence among research group were polyphagia, polyuria, nocturia, enuresis, loss of appetite, abdominal pain, vision disturbances, behavioural changes, Kussmaul breathing and mood swings (P <0.05). Patients from research group presented in more severe state initially with significantly lower pH levels by the time of hospitalization (7.29 (7.13-7.37) versus 7.33 (7.19-7.39) in control group, P = 0.02) and were more often admitted to intensive care unit (32.8% versus 25.2% in control group). There was no difference in HbA1c and C-peptide levels among groups, but we observed significantly higher prevalence of dyslipidemia (47.5% versus 23.4%, P <0.001) as well as lower albumin levels (39.2 ± 4.4 g/l versus 46 ± 15.2 g/l; P = 0.002) in patients with previous SARS-CoV-2 exposure.

Conclusion: Patients with previous SARS-CoV-2 exposure have more severe initial manifestation of type 1 diabetes with higher prevalence of classic diabetes symptoms and metabolic disturbances.