Increased frequency of severe diabetic ketoacidosis at type 1 diabetes onset among children during COVID-19 pandemic lockdown: an observational cohort study

Dżygało, Katarzyna; Nowaczyk, Jędrzej; Szwilling, Alicja; Kowalska, Agnieszka

doi:10.5114/pedm.2020.101003

Cited by 62 publications

(68 citation statements)

References 32 publications

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“…An increase in DKA frequency and severity has been prior reported in other countries [7][8][9][10][11][12]. As DKA is a life-threatening condition that requires complex management, sometimes possible only in an intensive care unit, the increased frequency of this metabolic complication could lead to extensive pressure on an already overwhelmed healthcare system.…”

Section: Discussionmentioning

confidence: 86%

“…A multicentre study reported an 80% increase in new T1DM cases in children, some of these patients having a confirmed history of SARS-CoV-2 infection [7]. Several studies reported a significant increase in the frequency of DKA present at the diagnosis of T1DM, with a higher percentage of the severe form of this metabolic complication [7][8][9][10][11][12]. It was hypothesized that an explanation for this phenomenon is the delay in the presentation of these patients caused by the parents' fear of accessing the healthcare system [9,10].…”

Section: Introductionmentioning

confidence: 99%

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The Impact of SARS-CoV-2 Pandemic on the New Cases of T1DM in Children. A Single-Centre Cohort Study

Boboc

Ilie

Ieșanu

et al. 2021

JPM

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Type 1 diabetes mellitus (T1DM) represents one of the most frequent chronic illnesses affecting children. The early diagnosis of this disease is crucial, as it plays a key role in preventing the development of a life-threatening acute complication: diabetic ketoacidosis. The etiopathogenetic role of viral infections has long been suggested and emerging data are pointing towards a complex bidirectional relationship between diabetes and COVID-19. The aim of this study is to assess the impact of the COVID-19 pandemic on the incidence and severity of new T1DM cases in children in Romania. We analyzed the differences between a group of 312 patients diagnosed with T1DM in the period 2003–2019 and a group of 147 children diagnosed during the pandemic. The data were investigated using statistical analysis of a series of relevant variables. The total number of newly diagnosed T1DM increased by 30.08% in the period March 2020–February 2021 compared to the previous years. The patients in the pandemic group had a higher mean age at the onset of T1DM, were less frequently living in an urban area, and presented a higher mean value of HbA1c. Diabetic ketoacidosis at the onset of T1DM was 67.40% more frequent, and a higher percentage of these patients presented with a severe form. The duration of T1DM symptoms did not differ significantly between the two groups. A number of 8 patients associated SARS-CoV-2 infection at the time of T1DM diagnosis.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

The Impact of SARS-CoV-2 Pandemic on the New Cases of T1DM in Children. A Single-Centre Cohort Study

Boboc

Ilie

Ieșanu

et al. 2021

JPM

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“… 21 Interestingly, a cross‐sectional study revealed that the DKA rate has raised to 12% in children with more severe cases which may be attributed to changes in social limitations. 16 Regelmann et al have confirmed the need for research assessing the impact of telemedicine on pediatric care outcomes. 22 …”

Section: Methodsmentioning

confidence: 96%

“… 15 While patient and society educations were focused on COVID‐19, maintaining regular education on other aspects of health, especially symptoms of diabetes, may be helpful to lower the prevalence of diabetic ketoacidosis (DKA). 16 …”

Section: Methodsmentioning

confidence: 99%

The overall impact of COVID‐19 on healthcare during the pandemic: A multidisciplinary point of view

Sabetkish

Rahmani

2021

Health Science Reports

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Background and Aims The Coronavirus disease 2019 (COVID‐19) pandemic globally changed the priorities of medical and surgical procedures. It has caused many healthcare systems to stop performing their routine screenings. Altering medical clinics to COVID‐19 referral centers, lockdowns, and the public fear to refer to medical centers caused a significant reduction in the referral rate; especially in the elderly. This short review article highlights the transform in clinical practice during the post‐COVID era and the need for future medical revolutions. Methods A comprehensive literature search was separately performed by both authors. The articles published between 2019 and August 2021 were included in this study and selected according to a quality appraisal method. Results We have summarized the possible corresponding changes in the diagnosis and treatment of all fields of medical care including internal medicine, surgical, and minor subcategories after the COVID‐19 pandemic. We have also discussed the potential impacts of the pandemic on all these different categories and subcategories of medicine, including the outpatient setting and clinical work. We do believe that the lack of routine check‐ups has led to an increase in the stage of disease in patients with a previously diagnosed problem. On the other hand, the dramatic change in the lifestyle of the population including restricted mobility and increased consumption of unhealthy food has caused metabolic syndrome and other new diseases that have not been diagnosed and properly managed. Conclusion Our findings revealed the urgent need for public health awareness. It indicated the need to carry out both psychological and screening approaches in the post‐COVID era to not miss patients with a chronic disease and new cases who were undiagnosed during the COVID pandemic.

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“…This has resulted in delays to child presentations at emergency departments and specialist centers (18). The diagnosis of conditions such as diabetes mellitus, dehydration, appendicitis, sepsis, and neoplastic diseases have been significantly delayed in many instances (19)(20)(21)(22). Limited access to health care has a particularly negative impact on newborns and young children (23,24).…”

Section: Essential Pediatric Carementioning

confidence: 99%

EAP and ECPCP Statement Risks for Children's Health During the COVID-19 Pandemic and a Call for Maintenance of Essential Pediatric Services

et al. 2021

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The COVID-19 pandemic and global lockdown have had drastic socioeconomic and psychological effects on countries and people, respectively. There has been limited access to health care and education. These negative consequences have had a significant impact on the well-being of children and adolescents. Therefore, the EAP and the ECPCP are requesting state, health, and education authorities as well as European pediatric societies and the healthcare professionals that special attention be given to this population and the problems they face as a result of the pandemic.

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Increased frequency of severe diabetic ketoacidosis at type 1 diabetes onset among children during COVID-19 pandemic lockdown: an observational cohort study

Cited by 62 publications

References 32 publications

The Impact of SARS-CoV-2 Pandemic on the New Cases of T1DM in Children. A Single-Centre Cohort Study

The Impact of SARS-CoV-2 Pandemic on the New Cases of T1DM in Children. A Single-Centre Cohort Study

The overall impact of COVID‐19 on healthcare during the pandemic: A multidisciplinary point of view

EAP and ECPCP Statement Risks for Children's Health During the COVID-19 Pandemic and a Call for Maintenance of Essential Pediatric Services

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