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4.
J Cyst Fibros ; 22(3): 456-463, 2023 May.
Article in English | MEDLINE | ID: covidwho-20234331

ABSTRACT

BACKGROUND: The COVID-19 pandemic resulted in the use of telehealth to deliver the cystic fibrosis (CF) care model, which recommends routine follow-up for monitoring of nutritional status, bacterial culture surveillance, pulmonary function testing, and screening for CF-related complications such as diabetes or osteoporosis. METHODS: The objective of this study was to use Cystic Fibrosis Foundation Patient Registry (CFFPR) data to quantify the extent to which persons with CF received the recommended components of the care model in 2019 versus 2020. A risk factor analysis was implemented to identify patient characteristics associated with attaining the recommended CF care and use of any telehealth using multivariable logistic regression. RESULTS: A total of 28,132 CFFPR participants were included in the study. The proportion of individuals meeting the recommendations for CF care was lower in 2020 for every indicator, and lower in adults compared to children. In adults, demographic, socioeconomic and CF-related disease covariates were significantly associated with both achieving an aggregate level of care and use of telehealth. In the pediatric population, minority race/ethnicity and markers of lower socioeconomic status were associated with a lower odds of telehealth use. In all analyses, having received the recommended level of care in 2019 was associated with a higher odds of both reported telehealth use and achieving the recommended elements of the CF care model in 2020. CONCLUSION: Fewer participants met recommendations for care in 2020 despite widespread use of telehealth, and use of telehealth did not equate to adherence to all aspects of CF care.


Subject(s)
COVID-19 , Cystic Fibrosis , Telemedicine , Adult , Humans , Child , United States/epidemiology , Cystic Fibrosis/diagnosis , Cystic Fibrosis/epidemiology , Cystic Fibrosis/therapy , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , Cystic Fibrosis Transmembrane Conductance Regulator
5.
Psychol Trauma ; 15(5): 888-894, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-20234244

ABSTRACT

OBJECTIVE: This study was conducted to determine psychological stress experienced by parents and posttraumatic emotional stress experienced by children during the COVID-19 pandemic. METHOD: The study has cross-sectional design and included parents who have 3- to 10 year-old children studying at kindergartens and primary schools under the Yozgat Directorate of National Education in Turkey, and who volunteered to participate in the study. The study was completed with 1,109 parents. School administrators were informed of the study and an online data collection form was distributed through parent WhatsApp groups. RESULTS: Fathers at or above the age of 37 were found to have lower Kessler Psychological Distress Scale (K10-PDS) scores (p < .05). In the study, K10-PDS scores of parents working as health care employees and Pediatric Emotional Distress Scale (PEDS) scores of their children were significantly higher than those of other groups (p < .05). K10-PDS scores of parents with children in the 3-6 age group who had behavioral changes, increased screen usage, and disturbed sleep and diet were found to be higher than those of other groups (p < .05). According to regression analysis K10-PDS scores of parents significantly explained 34% of children's PEDS score (R² = .340) (p < .001). CONCLUSIONS: This study determined that COVID-19 causes children to experience posttraumatic stress disorder. In addition, the study found increased stress levels of parents and children experiencing posttraumatic stress disorder. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
COVID-19 , Psychological Distress , Humans , Child , Child, Preschool , Cross-Sectional Studies , Pandemics , Parents/psychology , Stress, Psychological/etiology
7.
J Korean Med Sci ; 38(23): e195, 2023 Jun 12.
Article in English | MEDLINE | ID: covidwho-20234175

ABSTRACT

BACKGROUND: In Korea, during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, we responded to the uncertainty of treatments under various conditions, consistently playing catch up with the speed of evidence updates. Therefore, there was high demand for national-level evidence-based clinical practice guidelines for clinicians in a timely manner. We developed evidence-based and updated living recommendations for clinicians through a transparent development process and multidisciplinary expert collaboration. METHODS: The National Evidence-based Healthcare Collaborating Agency (NECA) and the Korean Academy of Medical Sciences (KAMS) collaborated to develop trustworthy Korean living guidelines. The NECA-supported methodological sections and 8 professional medical societies of the KAMS worked with clinical experts, and 31 clinicians were involved annually. We developed a total of 35 clinical questions, including medications, respiratory/critical care, pediatric care, emergency care, diagnostic tests, and radiological examinations. RESULTS: An evidence-based search for treatments began in March 2021 and monthly updates were performed. It was expanded to other areas, and the search interval was organized by a steering committee owing to priority changes. Evidence synthesis and recommendation review was performed by researchers, and living recommendations were updated within 3-4 months. CONCLUSION: We provided timely recommendations on living schemes and disseminated them to the public, policymakers and various stakeholders using webpages and social media. Although the output was successful, there were some limitations. The rigor of development issues, urgent timelines for public dissemination, education for new developers, and spread of several new COVID-19 variants have worked as barriers. Therefore, we must prepare systematic processes and funding for future pandemics.


Subject(s)
COVID-19 , Child , Humans , Adenosine-5'-(N-ethylcarboxamide) , Republic of Korea , SARS-CoV-2 , Practice Guidelines as Topic
8.
Eur Heart J ; 44(24): 2234-2243, 2023 06 25.
Article in English | MEDLINE | ID: covidwho-20234164

ABSTRACT

AIMS: A comprehensive nationwide study on the incidence and outcomes of COVID-19 vaccination-related myocarditis (VRM) is in need. METHODS AND RESULTS: Among 44 276 704 individuals with at least 1 dose of COVID-19 vaccination, the incidence and clinical courses of VRM cases confirmed by the Expert Adjudication Committee of the Korea Disease Control and Prevention Agency were analyzed. COVID-19 VRM was confirmed in 480 cases (1.08 cases per 100 000 persons). Vaccination-related myocarditis incidence was significantly higher in men than in women (1.35 vs. 0.82 per 100 000 persons, P < 0.001) and in mRNA vaccines than in other vaccines (1.46 vs. 0.14 per 100 000 persons, P < 0.001). Vaccination-related myocarditis incidence was highest in males between the ages of 12 and 17 years (5.29 cases per 100 000 persons) and lowest in females over 70 years (0.16 cases per 100 000 persons). Severe VRM was identified in 95 cases (19.8% of total VRM, 0.22 per 100 000 vaccinated persons), 85 intensive care unit admission (17.7%), 36 fulminant myocarditis (7.5%), 21 extracorporeal membrane oxygenation therapy (4.4%), 21 deaths (4.4%), and 1 heart transplantation (0.2%). Eight out of 21 deaths were sudden cardiac death (SCD) attributable to VRM proved by an autopsy, and all cases of SCD attributable to VRM were aged under 45 years and received mRNA vaccines. CONCLUSION: Although COVID-19 VRM was rare and showed relatively favorable clinical courses, severe VRM was found in 19.8% of all VRM cases. Moreover, SCD should be closely monitored as a potentially fatal complication of COVID-19 vaccination.


Subject(s)
COVID-19 Vaccines , COVID-19 , Myocarditis , Adolescent , Aged , Child , Female , Humans , Male , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Death, Sudden, Cardiac , mRNA Vaccines , Myocarditis/epidemiology , Myocarditis/etiology , Republic of Korea/epidemiology , Vaccination/adverse effects
9.
J Prev Med Public Health ; 56(3): 212-220, 2023 May.
Article in English | MEDLINE | ID: covidwho-20233931

ABSTRACT

OBJECTIVES: This study compared the epidemiological and clinical manifestations of patients hospitalized with respiratory syncytial virus (RSV) infection before and during the coronavirus disease 2019 (COVID-19) pandemic at a tertiary care hospital in Chiang Mai Province, Thailand. METHODS: This retrospective observational study utilized data from all cases of laboratory-confirmed RSV infection at Maharaj Nakorn Chiang Mai Hospital from January 2016 to December 2021. Differences in the clinical presentation of RSV infection before (2016 to 2019) and during (2020 to 2021) the COVID-19 pandemic were analyzed and compared. RESULTS: In total, 358 patients hospitalized with RSV infections were reported from January 2016 to December 2021. During the COVID-19 pandemic, only 74 cases of hospitalized RSV infection were reported. Compared to pre-pandemic levels, the clinical presentations of RSV infection showed statistically significant decreases in fever on admission (p=0.004), productive cough (p=0.004), sputum (p=0.003), nausea (p=0.03), cyanosis (p=0.004), pallor (p<0.001), diarrhea (p<0.001), and chest pain (p<0.001). Furthermore, vigilant measures to prevent the spread of COVID-19, including lockdowns, also interrupted the RSV season in Thailand from 2020 to 2021. CONCLUSIONS: The incidence of RSV infection was affected by the COVID-19 pandemic in Chiang Mai Province, Thailand, which also changed the clinical presentation and seasonal pattern of RSV infection in children.


Subject(s)
COVID-19 , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Child , Humans , Infant , Respiratory Syncytial Virus Infections/epidemiology , Child, Hospitalized , Pandemics , Thailand/epidemiology , COVID-19/epidemiology , Communicable Disease Control
10.
Medicina (Kaunas) ; 59(5)2023 May 03.
Article in English | MEDLINE | ID: covidwho-20233786

ABSTRACT

Background and Objectives: this study aimed to research links between C-reactive protein (CRP), lactate dehydrogenase (LDH), creatinekinase (CK), 25-OH vitamin D (25-OHD), ferritin (FER), high-density lipoprotein cholesterol (HDL)cholesterol and clinical severity in patients from the western part of Romania, and compare their potential use as biomarkers for intensive care units (ICU) admission and death in children, adults and elders. Materials and Methods: this study is a retrospective cohort study, performed on patients positively diagnosed with COVID-19. Available CRP, LDH, CK 25-OH vitamin D, ferritin, HDL cholesterol and clinical severity were recorded. The following were assessed: median group differences, association, correlation and receiver operating characteristic. Results: 381 children, 614 adults and 381 elders were studied between 1 March 2021 and 1 March 2022. Most children and adults presented mild symptomatology (53.28%, 35.02%, respectively), while most elders presented severe symptomatology (30.04%). ICU admission was 3.67% for children, 13.19% for adults and 46.09% for elders, while mortality was 0.79% for children, 8.63% for adults and 25.1% for elders. With the exception of CK, all other biomarkers showed some significant associations with clinical severity, ICU admission and death. Conclusions: CRP, LDH, 25-OH vitamin D, ferritin and HDL are important biomarkers for COVID-19 positive patients, especially in the pediatric population, while CK was mostly within normal ranges.


Subject(s)
COVID-19 , Humans , Child , Adult , Aged , COVID-19/diagnosis , Retrospective Studies , SARS-CoV-2 , Biomarkers , C-Reactive Protein/analysis , Cholesterol, HDL , Vitamin D , Ferritins
11.
NCHS Data Brief ; (469): 1-8, 2023 Jun.
Article in English | MEDLINE | ID: covidwho-20233715

ABSTRACT

With the disruptions to access and use of care caused by the COVID-19 pandemic, emergency department (ED) visit rates decreased from 2019 to 2020 among children and adolescents (1). The ED visit rate for children under age 1 year in 2020 was nearly one-half of the rate in 2019, and the rate for those aged 1-17 years decreased over the same period (2). This report uses data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) (3,4) to compare ED visits for children aged 0-17 from 2019 to 2020, by age group, sex, and race and ethnicity, and to assess changes in wait time at ED visits.


Subject(s)
COVID-19 , Adolescent , United States/epidemiology , Humans , Child , COVID-19/epidemiology , Pandemics , Emergency Service, Hospital , Ethnicity
12.
Allergy ; 78(3): 639-662, 2023 03.
Article in English | MEDLINE | ID: covidwho-20233683

ABSTRACT

The current monkeypox disease (MPX) outbreak constitutes a new threat and challenge for our society. With more than 55,000 confirmed cases in 103 countries, World Health Organization declared the ongoing MPX outbreak a Public Health Emergency of International Concern (PHEIC) on July 23, 2022. The current MPX outbreak is the largest, most widespread, and most serious since the diagnosis of the first case of MPX in 1970 in the Democratic Republic of the Congo (DRC), a country where MPX is an endemic disease. Throughout history, there have only been sporadic and self-limiting outbreaks of MPX outside Africa, with a total of 58 cases described from 2003 to 2021. This figure contrasts with the current outbreak of 2022, in which more than 55,000 cases have been confirmed in just 4 months. MPX is, in most cases, self-limiting; however, severe clinical manifestations and complications have been reported. Complications are usually related to the extent of virus exposure and patient health status, generally affecting children, pregnant women, and immunocompromised patients. The expansive nature of the current outbreak leaves many questions that the scientific community should investigate and answer in order to understand this phenomenon better and prevent new threats in the future. In this review, 50 questions regarding monkeypox virus (MPXV) and the current MPX outbreak were answered in order to provide the most updated scientific information and to explore the potential causes and consequences of this new health threat.


Subject(s)
Monkeypox virus , Monkeypox , Child , Female , Humans , Pregnancy , Disease Outbreaks , Monkeypox/diagnosis , Monkeypox/epidemiology
13.
BMJ Open ; 13(6): e072622, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-20233676

ABSTRACT

INTRODUCTION: Children with bone and joint infections are traditionally treated with intravenous antibiotics for 3-10 days, followed by oral antibiotics. Oral-only treatment has not been tested in randomised trials. METHODS AND ANALYSIS: Children (3 months to 18 years) will be randomised 1:1 with the experimental group receiving high-dose oral antibiotics and the control group receiving intravenous antibiotics with a shift in both groups to standard oral antibiotics after clinical and paraclinical improvement. Children in need of acute surgery or systemic features requiring intravenous therapy, including septic shock, are excluded. The primary outcome is defined as a normal blinded standardised clinical assessment 6 months after end of treatment. Secondary outcomes are non-acute treatment failure and recurrent infection. Outcomes will be compared by a non-inferiority assumption with an inferiority margin of 5%. ETHICS AND DISSEMINATION: The trial has the potential to reduce unnecessary hospitalisation and use of intravenous antibiotics in children with bone or joint infections. Due to the close follow-up, exclusion of severely ill children and predefined criteria for discontinuation of the allocated therapy, we expect the risk of treatment failure to be minimal. TRIAL REGISTRATION NUMBER: NCT04563325.


Subject(s)
COVID-19 , Humans , Child , Anti-Bacterial Agents/therapeutic use , SARS-CoV-2 , Treatment Outcome , Administration, Intravenous , Randomized Controlled Trials as Topic
14.
Int J Environ Res Public Health ; 20(11)2023 May 23.
Article in English | MEDLINE | ID: covidwho-20233633

ABSTRACT

The COVID-19 pandemic exacerbated the child mental health crisis and existing disparities. Child anxiety, depression, suicide attempts and completions, and mental-health-related emergency department visits significantly increased. In response to this crisis, the Administration for Strategic Preparedness and Response (ASPR) developed behavioral health task forces associated with funded pediatric centers of disaster excellence. The Health Resources and Services Administration (HRSA) funded the Pediatric Pandemic Network (PPN) to prepare for future endemics and pandemics, with behavioral health identified as a priority in mitigation, preparedness, response, and recovery. This commentary provides insights from pediatric disaster preparedness and response behavioral health subject matter experts. Our roles have been to identify how to build behavioral health professional competencies across disciplines and various medical settings and to strengthen emergency interdisciplinary behavioral health care capability regionally and at the national level. Specific examples of interdisciplinary training and demonstration projects are included as models for enhancing behavioral health situational awareness and developing curricula to support preparedness and response for the current ongoing pandemic and future natural and biological disasters. This commentary also includes a call to action for workforce development to move beyond a boots-on-the-ground mentality for pediatric behavioral health disaster preparedness and response toward a more inclusive role for behavioral health providers of varied specialties. This means that behavioral health providers should become more informed of federal programs in this area, seek further training, and find innovative ways to collaborate with their medical colleagues and community partners.


Subject(s)
COVID-19 , Disaster Planning , Disasters , Humans , Child , Pandemics , COVID-19/epidemiology , Professional Competence
15.
BMC Pediatr ; 23(1): 289, 2023 06 13.
Article in English | MEDLINE | ID: covidwho-20233578

ABSTRACT

BACKGROUND: Family-centered rounds (FCR) are fundamental to pediatric inpatient care. During the COVID-19 pandemic, we aimed to design and implement a virtual family-centered rounds (vFCR) process that allowed continuation of inpatient rounds while following physical distancing guidelines and preserving personal protective equipment (PPE). METHODS: A multidisciplinary team developed the vFCR process using a participatory design approach. From April through July 2020, quality improvement methods were used to iteratively evaluate and improve the process. Outcome measures included satisfaction, perceived effectiveness, and perceived usefulness of vFCR. Data were collected via questionnaire distributed to patients, families, staff and medical staff, and analyzed using descriptive statistics and content analysis. Virtual auditors monitored time per patient round and transition time between patients as balancing measures. RESULTS: Seventy-four percent (51/69) of health care providers surveyed and 79% (26/33) of patients and families were satisfied or very satisfied with vFCR. Eighty eight percent (61/69) of health care providers and 88% (29/33) of patients and families felt vFCR were useful. Audits revealed an average vFCR duration of 8.4 min (SD = 3.9) for a single patient round and transition time between patients averaged 2.9 min (SD = 2.6). CONCLUSION: Virtual family-centered rounds are an acceptable alternative to in-person FCR in a pandemic scenario, yielding high levels of stakeholder satisfaction and support. We believe vFCR are a useful method to support inpatient rounds, physical distancing, and preservation of PPE that may also be valuable beyond the pandemic. A rigorous process evaluation of vFCR is underway.


Subject(s)
COVID-19 , Inpatients , Humans , Child , Pandemics , Quality Improvement , Emotions
16.
Rev Gaucha Enferm ; 44: e20220075, 2023.
Article in English, Portuguese | MEDLINE | ID: covidwho-20233522

ABSTRACT

OBJECTIVE: To analyze the transitions experienced by mothers and children/adolescents with sickle cell disease after the emergence of the COVID-19 pandemic. METHOD: A qualitative study involving 19 mothers of children and adolescents with sickle cell disease. Data were obtained through semi-structured interviews via WhatsApp, followed by Thematic Analysis and Descending Hierarchical Classification with the help of Interface de R pour les Analyses Multidimensionnelles de Texteset de Questionnaires and interpreted in the light of Afaf Meleis' Transition Theory. RESULTS: Support from family members for displacement; mothers' adherence to the routine of daily stimuli and physical exercises favored healthy transitions; lack of remote health care; low socioeconomic resources; interruption of the physiotherapy service; and maternal overload favor unhealthy transitions. FINAL CONSIDERATIONS: Efforts/movements by mothers ensure the healthy transition of children/adolescents with sickle disease during the pandemic, while supporting their unhealthy transition.


Subject(s)
Anemia, Sickle Cell , COVID-19 , Female , Humans , Child , Adolescent , Mothers , COVID-19/epidemiology , Pandemics , Qualitative Research
17.
PLoS One ; 18(5): e0285375, 2023.
Article in English | MEDLINE | ID: covidwho-20233496

ABSTRACT

UK 'Lockdown' measures introduced in March 2020 aimed to mitigate the spread of COVID-19. Although seeking healthcare was still permitted within restrictions, paediatric emergency department attendances reduced dramatically and led to concern over risks caused by delayed presentation. Our aim was to gain insight into healthcare decisions faced by parents during the first wave of the COVID-19 pandemic and to understand if use of urgent healthcare, self-care, and information needs differed during lockdown as well as how parents perceived risks of COVID-19. We undertook qualitative telephone interviews with a purposive sample of parents living in the North East of England recruited through online advertising. We used a semi-structured interview schedule to explore past and current healthcare use, perceptions of risk and the impact of the pandemic on healthcare decisions. Interviews were transcribed and analysed using Thematic Analysis. Three major themes were identified which concerned (i) how parents made sense of risks posed to, and by their children, (ii) understanding information regarding health services and (iii) attempting to make the right decision. These themes contribute to the understanding of the initial impact of COVID-19 and associated restrictions on parental decisions about urgent healthcare for children. These findings are important to consider when planning for potential future public health emergencies but also in the wider context of encouraging appropriate use of urgent healthcare.


Subject(s)
COVID-19 , Emergency Medical Services , Child , Humans , COVID-19/epidemiology , Pandemics , Communicable Disease Control , United Kingdom/epidemiology , Parents
18.
J Am Acad Child Adolesc Psychiatry ; 62(7): 777-790, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-20233483

ABSTRACT

OBJECTIVE: We evaluate the mid-intervention (8 weeks) and short-term (16 weeks) impact of a culturally adapted multiple family group (MFG) intervention, "Amaka Amasanyufu," on the mental health of children with disruptive behavior disorders (DBDs) and primary caregivers in Uganda. METHOD: We analyzed data from the Strengthening mental health and research training in Sub-Saharan Africa (SMART) Africa-Uganda study. Schools were randomized to the following: a control group; an MFG facilitated by parent peers (MFG-PP); or an MFG facilitated by community health workers (MFG:CHW). All participants were blinded to interventions provided to other participants and study hypotheses. At 8 weeks and 16 weeks, we evaluated differences in depressive symptoms and self-concept among children and in mental health and caregiving-related stress among caregivers. Three-level linear mixed-effects models were fitted. Pairwise comparisons of post-baseline group means were performed using the Sidak adjustment for multiple comparisons and standardized mean differences. Data from 636 children with DBDs and caregivers (controls: n = 243, n = 10 schools; MFG-PP: n = 194, n = 8 schools; MFG-CHW: n = 199, n = 8 schools) were analyzed. RESULTS: There were significant group-by-time interactions for all outcomes, and differences were observed mid-intervention, with short-term effects at 16 weeks (end-intervention). MFG-PP and MFG-CHW children had significantly lower depressive symptoms and higher self-concept, whereas caregivers had significantly lower caregiving-related stress and fewer mental health problems, than controls. There was no difference between intervention groups. CONCLUSION: Amaka Amasanyufu MFG intervention is effective for reducing depressive symptoms and improving self-concept among children with DBDs while reducing parental stress and mental health problems among caregivers. Given the paucity of culturally adapted mental health interventions, this provides support for adaptation and scale-up in Uganda and other low-resource settings. CLINICAL TRIAL REGISTRATION INFORMATION: SMART Africa (Strengthening Mental Health Research and Training); https://clinicaltrials.gov/: NCT03081195.


Subject(s)
Mental Health , Problem Behavior , Humans , Child , Problem Behavior/psychology , Uganda , Attention Deficit and Disruptive Behavior Disorders
19.
Int J Environ Res Public Health ; 20(10)2023 05 10.
Article in English | MEDLINE | ID: covidwho-20233414

ABSTRACT

The number of adults with congenital heart disease (ACHD) has progressively increased in recent years to surpass that of children. This population growth has produced a new demand for health care. Moreover, the 2019 coronavirus pandemic has caused significant changes and has underlined the need for an overhaul of healthcare delivery. As a result, telemedicine has emerged as a new strategy to support a patient-based model of specialist care. In this review, we would like to highlight the background knowledge and offer an integrated care strategy for the longitudinal assistance of ACHD patients. In particular, the emphasis is on recognizing these patients as a special population with special requirements in order to deliver effective digital healthcare.


Subject(s)
Coronavirus Infections , Coronavirus , Heart Defects, Congenital , Telemedicine , Child , Humans , Adult , Heart Defects, Congenital/therapy , Heart Defects, Congenital/epidemiology , Delivery of Health Care , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy
20.
Int J Mol Sci ; 24(10)2023 May 17.
Article in English | MEDLINE | ID: covidwho-20233332

ABSTRACT

Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, although presenting less severe forms of the disease in children, seems to play a role in the development of other conditions, including type 1 diabetes mellitus (T1DM). After the beginning of the pandemic, an increase in the number of T1DM pediatric patients was observed in several countries, thus leading to many questions about the complex relationship between SARS-CoV-2 infection and T1DM. Our study aimed to highlight possible correlations between SARS-CoV-2 serology and T1DM onset. Therefore, we performed an observational retrospective cohort study that included 158 children diagnosed with T1DM in the period April 2021-April 2022. The presence or absence of SARS-CoV-2 and T1DM-specific antibodies and other laboratory findings were assessed. In the group of patients with positive SARS-CoV-2 serology, a higher percentage had detectable IA-2A antibodies, more children were positive for all three islet autoantibodies determined (GADA, ICA, and IA-2A), and a higher mean HbA1c value was found. No difference existed between the two groups regarding DKA presence and severity. A lower C-peptide level was found in the patients presenting diabetic ketoacidosis (DKA) at T1DM onset. When compared to a group of patients diagnosed before the pandemic, an increased incidence of both DKA and severe DKA, as well as a higher age at diagnosis and higher levels of HbA1c were present in our study group. These findings have important implications for the ongoing monitoring and management of children with T1DM after the COVID-19 pandemic and highlight the need for further research to better understand the complex relationship between SARS-CoV-2 infection and T1DM.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 1 , Diabetic Ketoacidosis , Child , Humans , Autoantibodies , Cohort Studies , COVID-19/epidemiology , Diabetic Ketoacidosis/diagnosis , Diabetic Ketoacidosis/epidemiology , Glycated Hemoglobin , Pandemics , Retrospective Studies , SARS-CoV-2
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