COVID-19 infection and autoimmunity not linked to developing type 1 diabetes in children: JAMA

An increased incidence of clinical diabetes has been reported in children with previous COVID-19.1,2 It is plausible that the virus may trigger an autoimmune response to the islets or hasten metabolic decompensation in persons with already established islets autoimmunity. We tested the hypothesis that previous SARS-CoV-2 infection was associated with autoimmunity, which predicts future type 1 diabetes.

In 2020 and 2021, a cross-sectional screening for islet autoantibodies and SARS-CoV-2 antibodies was offered to children and adolescents aged 1 to 18 years participating in the Autoimmunity Screening for Kids (ASK)3 in Colorado, US, and to children aged 1 to 10.9 years enrolled in the Fr1da study in Bavaria, Germany.

The results of the study are:

• Prior SARS-CoV-2 infections were identified in 1524 (32.3%) of 4717 Colorado youths and in 2862 (6.1%) of 47 253 Bavarian children
• Multiple islet autoantibodies were detected in 21 Colorado youths (0.45%) and in 141 Bavarian children (0.30%). In addition, 26 (0.55%) and 54 (0.11%) Colorado and Bavarian youths, respectively, were positive for a single high-affinity islet autoantibody.
• The prevalence of multiple or single high-affinity islet autoantibodies did not significantly differ between youths with vs without previous SARS-CoV-2 infection in Colorado or Bavaria
• Previous SARS-CoV-2 infection was not significantly associated with the presence of multiple islet autoantibodies or a single high-affinity islet autoantibody controlling for confounders.

Thus, the researchers concluded that there was no significant interaction between the study site and the association with SARS-CoV-2 infection, sex, age, or family history of type 1 diabetes

Reference:

Rewers M, Bonifacio E, Ewald D, et al. SARS-CoV-2 Infections and Presymptomatic Type 1 Diabetes Autoimmunity in Children and Adolescents From Colorado, USA, and Bavaria, Germany. JAMA. Published online August 05, 2022. doi:10.1001/jama.2022.14092

Keywords:

type 1 diabetes, COVID-19, infection, autoimmunity, Colorado, Bavaria, Germany, Adolescent Medicine, Marian Rewers, Ezio Bonifacio, Dominik Ewald, Cristy Geno Rasmussen, Xiaofan Jia, Laura Pyle, Anette-Gabriele Ziegler,JAMA