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Meta-Analysis
. 2022 Nov;94(11):5112-5127.
doi: 10.1002/jmv.27996. Epub 2022 Jul 22.

The global impact of COVID-19 pandemic on the incidence of pediatric new-onset type 1 diabetes and ketoacidosis: A systematic review and meta-analysis

Masoud Rahmati  1 , Maryam Keshvari  1 , Shahrzad Mirnasuri  2 , Dong K Yon  3 , Seung W Lee  4   5 , Jae Il Shin  6 , Lee Smith  7
Affiliations
Meta-Analysis

The global impact of COVID-19 pandemic on the incidence of pediatric new-onset type 1 diabetes and ketoacidosis: A systematic review and meta-analysis

Masoud Rahmati et al. J Med Virol. 2022 Nov.

Abstract

Viral infections may increase the risk of developing type 1 diabetes (T1D), and recent reports suggest that Coronavirus Disease 2019 (COVID-19) might have increased the incidence of pediatric T1D and/or diabetic ketoacidosis (DKA). Therefore, this meta-analysis aims to estimate the risk of global pediatric new-onset T1D, DKA, and severe DKA before and after the COVID-19 pandemic. A systematic search of MEDLINE/PubMed, CINAHL, Scopus, and EMBASE was conducted for articles published up to March 2022. A random-effects meta-analysis was performed to compare the relative risk of T1D and DKA among pediatric patients with T1D between the COVID-19 pre-pandemic and pandemic periods. We also compared glucose and HbA1c values in children who were newly diagnosed with T1D before and after the COVID-19 pandemic. The global incidence rate of T1D in the 2019 period was 19.73 per 100 000 children and 32.39 per 100 000 in the 2020 period. Compared with pre-COVID-19 pandemic, the number of worldwide pediatric new-onset T1D, DKA, and severe DKA during the first year of the COVID-19 pandemic increased by 9.5%, 25%, and 19.5%, respectively. Compared with pre-COVID-19 pandemic levels, the median glucose, and HbA1c values in newly diagnosed T1D children after the COVID-19 pandemic increased by 6.43% and 6.42%, respectively. The COVID-19 pandemic has significantly increased the risk of global pediatric new-onset T1D, DKA, and severe DKA. Moreover, higher glucose and HbA1c values in newly diagnosed T1D children after the COVID-19 pandemic mandates targeted measures to raise public and physician awareness.

Keywords: COVID-19; exercise; meta-analysis; physical activity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of study selection.
Figure 2
Figure 2
Forest plot of the logit event rates of numbers (A) and incidence (B) of pediatric new‐onset T1D before and after the COVID‐19 pandemic. CI, confidence interval; COVID‐19, coronavirus disease‐2019; T1D, type 1 diabetes
Figure 3
Figure 3
Forest plot of the risk of global pediatric DKA (A) and severe DKA (B) before and after the COVID‐19 pandemic. CI, confidence interval; COVID‐19, coronavirus disease‐2019; DKA, diabetic ketoacidosis
Figure 4
Figure 4
Forest plot of risk of pediatric hyperglycemia (A) and elevated HbA1c (B) before and after the COVID‐19 pandemic. CI, confidence interval; COVID‐19, coronavirus disease‐2019; HbA1c, glycosylated hemoglobin
See this image and copyright information in PMC

Comment in

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