Sharp Rise in New-Onset Pediatric Diabetes During the COVID-19 Pandemic.

INTRODUCTION: Recent studies report a significant impact of the COVID-19 pandemic on the incidence, severity, and management of diabetes. OBJECTIVE: To determine the incidence of new onset pediatric diabetes prepandemic versus during the pandemic and to analyze the presentation based on age, severity, HbA1c, body mass index, and COVID testing. METHODS: We conducted a retrospective review of all pediatric patients admitted with newly diagnosed type 1 and type 2 diabetes mellitus admitted to the American Family Children's Hospital (Madison, Wisconsin) from 2018 through 2021. Data included age at diagnosis, body mass index, hemoglobin A1c percent and pH at presentation, presence of autoimmune pancreatic antibodies, and COVID-19 polymerase chain reaction (PCR) results at admission in pre-COVID (January 2018-February 2020) versus during COVID (March 2020-December 2021). Statistical analysis was performed using SAS software with the incidences analyzed using univariate and multivariate Poisson regression analyses. RESULTS: During the pandemic, the incidence of both type 1 and type 2 diabetes mellitus increased significantly (69% and 225%, P < 0.001, respectively), and a higher number of patients had diabetic ketoacidosis. Type 1 diabetes patients with a body mass index greater than the 95th percentile increased from 11.1% to 16.9% (OR 0.62; 95% CI, 0.29-1.29; P = 0.19). Almost all patients were COVID-19 PCR negative at the time of diagnosis. CONCLUSIONS: A dramatic increase in number and severity of newly diagnosed pediatric diabetes cases was seen during the pandemic. The increase was not explained by factors such as changes in referral patterns or insurance coverage. Further work is needed to understand the impact of societal factors and the direct diabetogenic effect of SARS-CoV-2.

Characteristics Of Preterm With Sight Threatening Retinopathy Of Prematurity.

BACKGROUND: Retinopathy of prematurity (ROP) is a preventable and treatable vasoproliferative disorder of the retina which develops mostly in preterm babies. It is a leading cause of childhood blindness and more common in under developed countries. Prevalence of the severe ROP is 7.7% in Pakistan. We reviewed the characteristics of preterm babies with severe ROP to evaluate the predictors of sight threatening ROP. METHODS: Our study was conducted at the NICU of Aga Khan University Hospital which is a tertiary care private sector hospital in Karachi. Ninety-seven cases of severe ROP were found out of which 83 cases were enrolled. Data on determinants for ROP were collected including gestational age, birth weight, weight gain at two and four weeks, h/o blood transfusion, supplementary oxygen, presence of PDA and its treatment. Data analysis was done by using SPSS version 20.0. RESULTS: Frequency of severe ROP in our cohort was 5.95%. Mean gestational age for severe ROP was 28.27±1.79 and mean birth weight was 1069.16±271.71 grams. The overall mean weight gain per week in these babies was 94.62±75.64 grams. Supplementary oxygen was provided in almost 100% (82/83 cases) of cases. Surfactant was given to 56.6 % babies. PDA was found in 23 cases out of which 19 were treated by medical therapy whereas surgical treatment was done in 4 cases. CONCLUSIONS: Severe Retinopathy of prematurity was directly correlated with low birth weight, and gestational age. An average, weight gain in four weeks was lower in ROP babies (94.62±75.64 grams) than the recommended weight gain (WHO recommended 140-210 gm per week). This could be associated with the development and severity of ROP requiring treatment. Therefore, a prospective case control study is required to further identify risk factors associated with the above cohort. Screening and follow up of all such babies according to the international criteria is the need of the day.