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  • Lugar, MarijaDresden University of Technology (author)

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

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023
  • 10 s.

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  • LIBRIS-ID:oai:lup.lub.lu.se:9c7e0f0f-7442-411e-a0c2-32bad59098b3
  • https://lup.lub.lu.se/record/9c7e0f0f-7442-411e-a0c2-32bad59098b3URI
  • https://doi.org/10.1001/jama.2023.16348DOI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • 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 (author)
  • Achenbach, PeterHelmholtz Zentrum München,Technical University of Munich (author)
  • von dem Berge, TheklaChildren's Hospital Auf der Bult (author)
  • Berner, ReinhardUniversity Clinic Carl Gustav Carus at the TU Dresden (author)
  • Besser, Rachel E JOxford University Hospital (author)
  • Casteels, KristinaUniversity Hospitals Leuven,Catholic University of Leuven (author)
  • 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)
  • Gemulla, GitaDresden University of Technology,University Clinic Carl Gustav Carus at the TU Dresden (author)
  • Kordonouri, OlgaChildren's Hospital Auf der Bult (author)
  • Lindner, AnnettDresden University of Technology (author)
  • 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)
  • Müller, DeniseDresden University of Technology (author)
  • Oltarzewski, MariuszNational Research Institute of Mother and Child (author)
  • Rochtus, AnneUniversity Hospitals Leuven,Catholic University of Leuven (author)
  • Scholz, MarlonTechnical University of Munich,Helmholtz Zentrum München (author)
  • Szypowska, AgnieszkaMedical University of Warsaw (author)
  • Todd, John AUniversity of Oxford (author)
  • Ziegler, Anette-GabrieleTechnical University of Munich,Helmholtz Zentrum München (author)
  • Bonifacio, EzioHelmholtz Zentrum München,University Clinic Carl Gustav Carus at the TU Dresden,Dresden University of Technology (author)
  • Dresden University of TechnologyHelmholtz Zentrum München (creator_code:org_t)
  • GPPAD Study Group

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  • In:JAMA330:120098-7484

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