Pediatric COVID-19 and Diabetes: An Investigation into the Intersection of Two Pandemics

Abstract

Coronavirus disease 2019 (COVID-19) is a complex infectious disease caused by the SARS-CoV-2 virus, and it currently represents a worldwide public health emergency. The pediatric population is less prone to develop severe COVID-19 infection, but children presenting underlying medical conditions, such as diabetes mellitus, are thought to be at increased risk of developing more severe forms of COVID-19. Diabetic children face new challenges when infected with SARS-CoV-2. On one hand, the glycemic values become substantially more difficult to manage as COVID-19 is a predisposing factor for hyperglycemia. On the other hand, alongside other risk factors, high glycemic values are incriminated in modulating immune and inflammatory responses, leading to potentially severe COVID-19 cases in the pediatric population. Also, there are hypotheses of SARS-CoV-2 being diabetogenic itself, but this information is still to be confirmed. Furthermore, it is reported that there was a noticeable increase in the number of cases of new-onset type 2 diabetes among the pediatric population, and the complications in these patients with COVID-19 include the risk of developing autoimmune diseases under the influence of stress. Additionally, children with diabetes mellitus are confronted with lifestyle changes dictated by the pandemic, which can potentially lead to the onset or exacerbation of a potential underlying anxiety disorder or depression. Since the literature contains a series of unknowns related to the impact of COVID-19 in both types of diabetes in children, the purpose of our work is to bring together the data obtained so far and to identify potential knowledge gaps and areas for future investigation regarding COVID-19 and the onset of diabetes type 1 or type 2 among the pediatric population.

Potential Beneficial Effects of Naringin and Naringenin on Long COVID—A Review of the Literature

“…The pathogenesis of new-onset diabetes is mainly related to pancreatic autoimmunity, pancreatic injury, pro-inflammatory cytokine storms, the triggering of steroid drugs, and underlying diabetic activation of the body. T1D is an autoimmune disease, and the invasion of SARS-CoV-2 leads to autoimmune hyperactivation in the body [ 196 ]. Additionally, researchers have found pancreatic damage in some COVID-19 patients [ 197 ].…”

Pediatric endocarditis - a stone left after the pandemic cascade

“…At the same time, during this period there was an information peak regarding the micronutrition approach in pediatric respiratory pathology (e.g. bronchiolitis, pneumonia, COVID-19), with an emphasis on the immunomodulatory role of vitamin D. Heart involvement in multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a newly identified and challenging pathology that calls for prompt and accurate diagnosis, as well as the correct type of care ( Kostik et al., 2022 ; Fotea et al., 2023 ; Lupu et al., 2023 ; Nicolae et al., 2023 ). Pediatric inflammatory multisystem syndrome—temporarily associated with SARS-CoV-2 (PIMS-TS) and presenting a phenotype mimicking Kawasaki disease (KD) (‘Kawa-COVID-19’)— was also identified in a small proportion of pediatric patients ( Basu and Das, 2021 ; Mihai et al., 2023 ).…”

“…A trained innate immune system, a young and healthy immune system, and lower expression of the angiotensin-converting enzyme (ACE)-2 receptor (the target of SARS-CoV-2) gene may be reasons why children present milder COVID-19 symptoms than adults ( Clark and Pathan, 2021 ). However, children can experience long-term COVID-19 side effects similar to those in adults, such as neurological and cardiac morbidity ( Fotea et al., 2023 ). Severe acute infection with COVID-19 can have a negative impact on the cardiovascular, gastrointestinal, nervous, hematological, and renal systems ( Axelerad et al., 2022 ; Kalyanaraman and Anderson, 2022 ; Mihai et al., 2022 ; Grigore et al., 2023 ).…”