Guy Todd Alonso1, Osagie Ebekozien2, Mary Pat Gallagher3, Saketh Rompicherla2, Sarah K Lyons4, Abha Choudhary5, Shideh Majidi1, Catherina T Pinnaro6, Sadana Balachandar7, Mariam Gangat7, Alissa Jeanne Curda Roberts8, Brynn E Marks9, Ana Creo10, Janine Sanchez11, Tossaporn Seeherunvong11, Jose Jimenez-Vega12, Neha S Patel13, Jamie R Wood14, Liana Gabriel3, Kathryn M Sumpter15, Meredith Wilkes16, Robert Rapaport16, Anna Cymbaluk4, Jenise C Wong17, Srinath Sanda17, Anastasia Albanese-O'neill18. 1. Barbara Davis Center, University of Colorado, Aurora, Colorado, USA. 2. T1D Exchange, Boston, Massachusetts, USA. 3. Hassenfeld Children's Hospital at NYU Langone, New York, New York, USA. 4. Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA. 5. University of Texas Southwestern, Dallas, Texas, USA. 6. The University of Iowa Stead Family Department of Pediatrics, Iowa City, Iowa, USA. 7. Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. 8. Department of Pediatrics, University of Washington, Seattle, Washington, USA. 9. Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA. 10. Mayo Clinic, Rochester, Minnesota, USA. 11. Miller School of Medicine, University of Miami, Miami, Florida, USA. 12. Helen DeVos Children's Hospital, Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA. 13. Milton S. Hershey Medical Center, PennState Health, Hershey, Pennsylvania, USA. 14. UH Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio, USA. 15. University of Tennessee Health Science Center, Le Bonheur Children's Hospital Memphis, Memphis, Tennessee, USA. 16. Icahn School of Medicine at Mount Sinai, New York, New York, USA. 17. Madison Clinic for Pediatric Diabetes, University of California San Francisco, San Francisco, California, USA. 18. University of Florida College of Medicine, Gainesville, Florida, USA.
Abstract
BACKGROUND: Diabetes is a risk factor for poor COVID-19 outcomes, but pediatric patients with type 1 diabetes are poorly represented in current studies. METHODS: T1D Exchange coordinated a US type 1 diabetes COVID-19 registry. Forty-six diabetes centers submitted pediatric cases for patients with laboratory confirmed COVID-19. Associations between clinical factors and hospitalization were tested with Fisher's Exact Test. Logistic regression was used to calculate odds ratios for hospitalization. RESULTS: Data from 266 patients with previously established type 1 diabetes aged <19 years with COVID-19 were reported. Diabetic ketoacidosis (DKA) was the most common adverse outcome (n = 44, 72% of hospitalized patients). There were four hospitalizations for severe hypoglycemia, three hospitalizations requiring respiratory support (one of whom was intubated and mechanically ventilated), one case of multisystem inflammatory syndrome in children, and 10 patients who were hospitalized for reasons unrelated to COVID-19 or diabetes. Hospitalized patients (n = 61) were more likely than nonhospitalized patients (n = 205) to have minority race/ethnicity (67% vs 39%, P < 0.001), public insurance (64% vs 41%, P < 0.001), higher A1c (11% [97 mmol/mol] vs 8.2% [66 mmol/mol], P < 0.001), and lower insulin pump and lower continuous glucose monitoring use (26% vs 54%, P < 0.001; 39% vs 75%, P < 0.001). Age and gender were not associated with risk of hospitalization. Higher A1c was significantly associated with hospitalization, with an odds ratio of 1.56 (1.34-1.84) after adjusting for age, gender, insurance, and race/ethnicity. CONCLUSIONS: Higher A1c remained the only predictor for hospitalization with COVID-19. Diabetic ketoacidosis is the primary concern among this group.
BACKGROUND:Diabetes is a risk factor for poor COVID-19 outcomes, but pediatric patients with type 1 diabetes are poorly represented in current studies. METHODS: T1D Exchange coordinated a US type 1 diabetesCOVID-19 registry. Forty-six diabetes centers submitted pediatric cases for patients with laboratory confirmed COVID-19. Associations between clinical factors and hospitalization were tested with Fisher's Exact Test. Logistic regression was used to calculate odds ratios for hospitalization. RESULTS: Data from 266 patients with previously established type 1 diabetes aged <19 years with COVID-19 were reported. Diabetic ketoacidosis (DKA) was the most common adverse outcome (n = 44, 72% of hospitalized patients). There were four hospitalizations for severe hypoglycemia, three hospitalizations requiring respiratory support (one of whom was intubated and mechanically ventilated), one case of multisystem inflammatory syndrome in children, and 10 patients who were hospitalized for reasons unrelated to COVID-19 or diabetes. Hospitalized patients (n = 61) were more likely than nonhospitalized patients (n = 205) to have minority race/ethnicity (67% vs 39%, P < 0.001), public insurance (64% vs 41%, P < 0.001), higher A1c (11% [97 mmol/mol] vs 8.2% [66 mmol/mol], P < 0.001), and lower insulin pump and lower continuous glucose monitoring use (26% vs 54%, P < 0.001; 39% vs 75%, P < 0.001). Age and gender were not associated with risk of hospitalization. Higher A1c was significantly associated with hospitalization, with an odds ratio of 1.56 (1.34-1.84) after adjusting for age, gender, insurance, and race/ethnicity. CONCLUSIONS: Higher A1c remained the only predictor for hospitalization with COVID-19. Diabetic ketoacidosis is the primary concern among this group.
Authors: Andrew R Lavik; Osagie Ebekozien; Nudrat Noor; G Todd Alonso; Sarit Polsky; Scott M Blackman; Justin Chen; Sarah D Corathers; Carla Demeterco-Berggren; Mary Pat Gallagher; Margaret Greenfield; Ashley Garrity; Saketh Rompicherla; Robert Rapaport; Nana-Hawa Yayah Jones Journal: J Clin Endocrinol Metab Date: 2022-06-16 Impact factor: 6.134
Authors: Anas Elgenidy; Ahmed K Awad; Khaled Saad; Mostafa Atef; Hatem Helmy El-Leithy; Ahmed A Obiedallah; Emad M Hammad; Faisal-Alkhateeb Ahmad; Ahmad M Ali; Hamad Ghaleb Dailah; Amira Elhoufey; Samaher Fathy Taha Journal: Pediatr Res Date: 2022-08-11 Impact factor: 3.953