SARS-CoV-2 Infection and Development of Islet Autoimmunity in Early Childhood

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SARS-CoV-2 Infection and Development of Islet Autoimmunity in Early Childhood

Lugar, Marija (author): Dresden University of Technology

Eugster, Anne (author): Dresden University of Technology

Achenbach, Peter (author): Helmholtz Zentrum München,Technical University of Munich

von dem Berge, Thekla (author): Children's Hospital Auf der Bult

Berner, Reinhard (author): University Clinic Carl Gustav Carus at the TU Dresden

Besser, Rachel E J (author): Oxford University Hospital

Casteels, Kristina (author): Catholic University of Leuven,University Hospitals Leuven

Elding Larsson, Helena (author): Lund University,Lunds universitet,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Pediatrisk endokrinologi,Forskargrupper vid Lunds universitet,Department of Clinical Sciences, Malmö,Faculty of Medicine,Paediatric Endocrinology,Lund University Research Groups,Skåne University Hospital

Gemulla, Gita (author): University Clinic Carl Gustav Carus at the TU Dresden,Dresden University of Technology

Kordonouri, Olga (author): Children's Hospital Auf der Bult

Lindner, Annett (author): Dresden University of Technology

Lundgren, Markus (author): Lund University,Lunds universitet,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Pediatrisk endokrinologi,Forskargrupper vid Lunds universitet,Department of Clinical Sciences, Malmö,Faculty of Medicine,Paediatric Endocrinology,Lund University Research Groups,Central Hospital Kristianstad

Müller, Denise (author): Dresden University of Technology

Oltarzewski, Mariusz (author): National Research Institute of Mother and Child

Rochtus, Anne (author): Catholic University of Leuven,University Hospitals Leuven

Scholz, Marlon (author): Technical University of Munich,Helmholtz Zentrum München

Szypowska, Agnieszka (author): Medical University of Warsaw

Todd, John A (author): University of Oxford

Ziegler, Anette-Gabriele (author): Technical University of Munich,Helmholtz Zentrum München

Bonifacio, Ezio (author): University Clinic Carl Gustav Carus at the TU Dresden,Helmholtz Zentrum München,Dresden University of Technology

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2023
2023
English 10 s.
In: JAMA. - 0098-7484. ; 330:12

Related links:: http://dx.doi.org/10...; show more...; https://lup.lub.lu.s...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

IMPORTANCE: The incidence of diabetes in childhood has increased during the COVID-19 pandemic. Elucidating whether SARS-CoV-2 infection is associated with islet autoimmunity, which precedes type 1 diabetes onset, is relevant to disease etiology and future childhood diabetes trends.OBJECTIVE: To determine whether there is a temporal relationship between SARS-CoV-2 infection and the development of islet autoimmunity in early childhood.DESIGN, SETTING, AND PARTICIPANTS: Between February 2018 and March 2021, the Primary Oral Insulin Trial, a European multicenter study, enrolled 1050 infants (517 girls) aged 4 to 7 months with a more than 10% genetically defined risk of type 1 diabetes. Children were followed up through September 2022.EXPOSURE: SARS-CoV-2 infection identified by SARS-CoV-2 antibody development in follow-up visits conducted at 2- to 6-month intervals until age 2 years from April 2018 through June 2022.MAIN OUTCOMES AND MEASURES: The development of multiple (≥2) islet autoantibodies in follow-up in consecutive samples or single islet antibodies and type 1 diabetes. Antibody incidence rates and risk of developing islet autoantibodies were analyzed.RESULTS: Consent was obtained for 885 (441 girls) children who were included in follow-up antibody measurements from age 6 months. SARS-CoV-2 antibodies developed in 170 children at a median age of 18 months (range, 6-25 months). Islet autoantibodies developed in 60 children. Six of these children tested positive for islet autoantibodies at the same time as they tested positive for SARS-CoV-2 antibodies and 6 at the visit after having tested positive for SARS-CoV-2 antibodies. The sex-, age-, and country-adjusted hazard ratio for developing islet autoantibodies when the children tested positive for SARS-CoV-2 antibodies was 3.5 (95% CI, 1.6-7.7; P = .002). The incidence rate of islet autoantibodies was 3.5 (95% CI, 2.2-5.1) per 100 person-years in children without SARS-CoV-2 antibodies and 7.8 (95% CI, 5.3-19.0) per 100 person-years in children with SARS-CoV-2 antibodies (P = .02). Islet autoantibody risk in children with SARS-CoV-2 antibodies was associated with younger age (<18 months) of SARS-CoV-2 antibody development (HR, 5.3; 95% CI, 1.5-18.3; P = .009).CONCLUSION AND RELEVANCE: In young children with high genetic risk of type 1 diabetes, SARS-CoV-2 infection was temporally associated with the development of islet autoantibodies.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

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