1. Has COVID-19 Delayed the Diagnosis and Worsened the Presentation of Type 1 Diabetes in Children?
- Author
-
Rabbone, Ivana, Schiaffini, Riccardo, Cherubini, Valentino, Maffeis, Claudio, Scaramuzza, Andrea, Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetes (Enrica Bertelli, Lucia, Ferlito, Adriana, Bobbio, Eleonardo, Schieven, Maurizio, Delvecchio, Giulio, Maltoni, Petra, Reinstadler, Barbara, Felappi, Francesco, Gallo, Carlo, Ripoli, Filomena, Pascarella, Filomena, A Stamati, Donatella Lo Presti, Felice, Citriniti, Stefano, Tumini, Maria, Zampolli, Rosaria De Marco, Claudio, Cavalli, Valeria De Donno, Sonia, Toni, Maria Susanna Coccioli, Giuseppe, D'Annunzio, Paola Sogno Valin, Dante, Cirillo, Silvia, Sordelli, Fortunato, Lombardo, Riccardo, Bonfanti, Chiara, Mameli, Predieri, Barbara, Adriana, Franzese, Dario, Iafusco, Silvia, Savastio, Gavina, Piredda, Francesca, Cardella, Valeria, Calcaterra, Emioli, Randazzo, Anna, Favia, Tosca, Suprani, Alessandra, Lasagni, Novella, Rapini, Irene, Rutigliano, Alberto, Gaiero, Luisa De Sanctis, Vittoria, Cauvin, Marta, Minute, Gianluca, Tornese, Francesca, Franco, Gianluca, Musolino, Marco, Marigliano, Silvia, Innaturato, Claudia, Arnaldi), Rabbone, Ivana, Schiaffini, Riccardo, Cherubini, Valentino, Maffeis, Claudio, Scaramuzza, Andrea, Tornese, Gianluca, Rabbone, I., Schiaffini, R., Cherubini, V., Maffeis, C., Scaramuzza, A., Italian Study Group of Diabetes of, Isped, and Iafusco, D
- Subjects
Research design ,Male ,Pediatrics ,Delayed Diagnosis ,Cross-sectional study ,Endocrinology, Diabetes and Metabolism ,Clinical Laboratory Technique ,0302 clinical medicine ,COVID-19 Testing ,030212 general & internal medicine ,Viral ,Child ,Emergency Service ,Delayed Diagnosi ,COVID-19 ,diabetes mellitus type 1 ,Italy ,Adolescent ,Child, Preschool ,Clinical Laboratory Techniques ,Coronavirus Infections ,Cross-Sectional Studies ,Diabetes Mellitus, Type 1 ,Diabetic Ketoacidosis ,Emergency Service, Hospital ,Female ,Humans ,Infant ,Pandemics ,Pneumonia, Viral ,SARS-CoV-2 ,Betacoronavirus ,medicine.symptom ,Human ,Type 1 ,medicine.medical_specialty ,Diabetic ketoacidosis ,030209 endocrinology & metabolism ,Asymptomatic ,Diabetic Ketoacidosi ,03 medical and health sciences ,Hospital ,Diabetes mellitus ,Internal Medicine ,medicine ,Diabetes Mellitus ,Preschool ,Advanced and Specialized Nursing ,Cross-Sectional Studie ,Type 1 diabetes ,Pandemic ,business.industry ,Coronavirus Infection ,Emergency department ,Pneumonia ,medicine.disease ,business - Abstract
OBJECTIVE To evaluate whether the diagnosis of pediatric type 1 diabetes or its acute complications changed during the early phase of the coronavirus disease 2019 (COVID-19) pandemic in Italy. RESEARCH DESIGN AND METHODS This was a cross-sectional, web-based survey of all Italian pediatric diabetes centers to collect diabetes, diabetic ketoacidosis (DKA), and COVID-19 data in patients presenting with new-onset or established type 1 diabetes between 20 February and 14 April in 2019 and 2020. RESULTS Fifty-three of 68 centers (77.9%) responded. There was a 23% reduction in new diabetes cases in 2020 compared with 2019. Among those newly diagnosed patients who presented in a state of DKA, the proportion with severe DKA was 44.3% in 2020 vs. 36.1% in 2019 (P = 0.03). There were no differences in acute complications. Eight patients with asymptomatic or mild COVID-19 had laboratory-confirmed severe acute respiratory syndrome coronavirus 2. CONCLUSIONS The COVID-19 pandemic might have altered diabetes presentation and DKA severity. Preparing for any “second wave” requires strategies to educate and reassure parents about timely emergency department attendance for non–COVID-19 symptoms.
- Published
- 2020