Covid-19 infection in children and adolescents and its association with type 1 diabetes mellitus (T1d) presentation and management

Abstract

Children seem to be affected by the new SARS-CoV-2 virus less severely than adults, with better prognosis and low mortality. Serious complications of COVID-19 infection in children include multisystem inflammatory response syndrome in COVID-19 infection (MIS-C), myo-or pericarditis and, less frequently, long COVID syndrome. On the other hand, adults with type 1 (T1D) or type 2 diabetes (T2D) are among the most vulnerable groups affected by COVID-19, with increased morbidity and mortality. Moreover, an association of SARS-CoV-2 with diabetes has been observed, possibly affecting the frequency and severity of the first clinical presentation of T1D or T2D, as well as the development of acute diabetes after COVID-19 infection. The present review summarizes the current data on the incidence of T1D among children and adolescents during the COVID-19 pandemic, as well as its severity. Moreover, it reports on the types of newly diagnosed diabetes after COVID infection and the possible pathogenetic mechanisms. Additionally, this study presents current data on the effect of SARS-CoV-2 on diabetes control in patients with known T1D and on the severity of clinical presentation of COVID infection in these patients. Finally, this review discusses the necessity of immunization against COVID 19 in children and adolescents with T1D.

“Diabetes is really simple on paper, but really complicated when you actually have it”: Understanding the daily stressors of adolescents living with Type 1 diabetes

“…Most participants feared they would be severely affected by COVID‐19. Studies have shown that high‐risk groups including individuals with T1D are at risk for severe infection, hospitalization, increased mortality rates, and anxiety (Caballero et al, 2020; Karavanaki et al, 2023; Wade et al, 2022). The fear of COVID‐19 added to the experience of daily stress and the feeling of social isolation.…”

“…T1D represents a lifelong diagnosis and requires significant day to day management tasks for optimal outcomes (Rechenberg et al, 2017; Shubrook et al, 2018). Adolescents with T1D experience stressors associated with their developmental stage (Chao et al, 2016; Hedge et al, 2023; Jaser et al, 2017), and are transitioning to independent management of their diabetes, which is often associated with additional stress and family conflict on top of the already complex requirements of the disease (Brazeau et al, 2018; Ersig et al, 2016; Karavanaki et al, 2023). To best understand how to develop interventions aimed at stress reduction and improving T1D self‐management in adolescents, we aimed to explore how adolescents perceived and described the daily stress of living with diabetes and how those stressors impact their general daily management and lifestyle.…”

Risk Factors for Pediatric Critical COVID-19: A Systematic Review and Meta-Analysis

“…Furthermore, the level of risk associated with specific medical conditions can vary depending on how well they are managed. For instance, there is evidence to suggest that diabetic children who maintain good glycemic control are at no greater risk than the general population [40, 78, 155, 156]. Similarly, children with congenital heart disease who have undergone surgical repair or no longer have a hemodynamically significant abnormality may be at lower risk [35, 157].…”

Endocrinological Involvement in Children and Adolescents Affected by COVID-19: A Narrative Review

“…The association between COVID-19 infection and type 1 diabetes (T1D) in children has been extensively studied in the last three years. However, the available data regarding the trend of incidence of newly diagnosed T1D during the COVID-19 pandemic are conflicting [ 87 , 88 ].…”