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SARS-CoV-2 Infectio...
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Lugar, MarijaDresden University of Technology
(author)
SARS-CoV-2 Infection and Development of Islet Autoimmunity in Early Childhood
- Article/chapterEnglish2023
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LIBRIS-ID:oai:lup.lub.lu.se:9c7e0f0f-7442-411e-a0c2-32bad59098b3
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https://lup.lub.lu.se/record/9c7e0f0f-7442-411e-a0c2-32bad59098b3URI
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https://doi.org/10.1001/jama.2023.16348DOI
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Language:English
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Summary in:English
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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.
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Eugster, AnneDresden University of Technology
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Achenbach, PeterHelmholtz Zentrum München,Technical University of Munich
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von dem Berge, TheklaChildren's Hospital Auf der Bult
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Berner, ReinhardUniversity Clinic Carl Gustav Carus at the TU Dresden
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Besser, Rachel E JOxford University Hospital
(author)
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Casteels, KristinaCatholic University of Leuven,University Hospitals Leuven
(author)
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Elding Larsson, HelenaLund 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(Swepub:lu)pedi-hla
(author)
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Gemulla, GitaUniversity Clinic Carl Gustav Carus at the TU Dresden,Dresden University of Technology
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Kordonouri, OlgaChildren's Hospital Auf der Bult
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Lindner, AnnettDresden University of Technology
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Lundgren, MarkusLund 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(Swepub:lu)med-mn2
(author)
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Müller, DeniseDresden University of Technology
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Oltarzewski, MariuszNational Research Institute of Mother and Child
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Rochtus, AnneUniversity Hospitals Leuven,Catholic University of Leuven
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Scholz, MarlonTechnical University of Munich,Helmholtz Zentrum München
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Szypowska, AgnieszkaMedical University of Warsaw
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Todd, John AUniversity of Oxford
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Ziegler, Anette-GabrieleTechnical University of Munich,Helmholtz Zentrum München
(author)
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Bonifacio, EzioDresden University of Technology,Helmholtz Zentrum München,University Clinic Carl Gustav Carus at the TU Dresden
(author)
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Dresden University of TechnologyHelmholtz Zentrum München
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GPPAD Study Group
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Eugster, Anne
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Rochtus, Anne
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