COVID-19 Infection May Cause New Cases of Diabetes in Children

Children and adolescents previously infected with COVID-19 were found to be at increased risk of developing diabetes. These findings were published in Morbidity and Mortality Weekly Report.

Investigators conducted a study to assess whether prior COVID-19 infection is associated with new onset diabetes in children and adolescents. The investigators suggested this association may be due to the effect of the SARS-CoV-2 virus on organ systems, either via direct attack on pancreatic cells with subsequent alteration to glycolysis or precipitation of prediabetes to diabetes.

Data were sourced from the IQVIA and HealthVerity claims databases. The study included children and adolescents with no history of prediabetes or diabetes who were diagnosed with either COVID-19 or acute respiratory infection (ARI) between March 2020 and June 2021. Patients were matched by age and sex against a second cohort that included healthy patients and those diagnosed with ARI prior to the COVID-19 pandemic. The investigators compared the estimated incidence of new-onset diabetes between both groups.

Among patients diagnosed with COVID-19 infection for whom data were sourced from the IQVIA (n=80,893) and HealthVerity (n=439,439) claims databases, the mean age was 12.3 ± 4.3 and 12.7 ± 3.8 years, 50.1% and 50.1% were girls, and 0.7% and 0.9% required hospitalization, respectively.

Among patients in both the IQVIA and HealthVerity groups with COVID-19 infection, diabetes was diagnosed in 0.08% and 0.25% compared with 0.03% and 0.19% among those without COVID-19 infection, respectively for both. The investigators noted a 166% increased risk for incident diabetes among patients with vs those without COVID-19 infection (hazard ratio [HR], 2.66; 95% CI, 1.98-3.56). Of note, the risk for incident diabetes among patients in the prepandemic cohort did not significantly differ between those with vs without ARI (HR, 0.99; 95% CI, 0.84-1.15).

Further analysis was conducted among patients diagnosed with diabetes to compare the incidence of diabetic ketoacidosis (DKA) between those with and without COVID-19 infection. Among patients with COVID-19 infection, DKA was diagnosed in 40.2% of those in the HealthVerity group vs 48.5% of those in the IQVIA group. Of patients without COVID-19 infection, DKA was diagnosed in 13.6% and 29.7% of those in the HealthVerity and IQVIA groups, respectively.

Limitations of this study included that diabetes diagnoses were determined on the basis of a single ICD-10-CM code, the lack of laboratory findings at the time of diagnosis, the inability to distinguish between type 1 and type 2 diabetes, and the lack of information on race/ethnicity and obesity status.

“These data suggest an increased risk for diabetes among [children and adolescents] with COVID-19 [infection], which is supported by independent studies in adults,” the investigators noted. “These findings underscore the importance of COVID-19 prevention among all age groups, including vaccination for all eligible children and adolescents, and chronic disease prevention and treatment,” the investigators concluded.

Reference

Barrett CE, Koyama AK, Alvarez P, et al. Risk for newly diagnosed diabetes >30 days after SARS-CoV-2 infection among persons aged <18 years—United States, March 1, 2020-June 28, 2021. MMWR Morb Mortal Wkly Rep. Published online January 7, 2022.  doi:10.15585/mmwr.mm7102e2