Ketoacidosis in new-onset type 1 diabetes: did the severity increase during the COVID-19 pandemic?
| Autor: | Alice Mirante, Isabel Dinis, Joana Serra-Caetano, Joana Santos, Ana Isabel B R Martins, Rita Cardoso, Adriana I S Formiga, Crisbety M S Pinho, Teresa A Botelho |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Risk Pediatrics medicine.medical_specialty Delayed Diagnosis Adolescent Endocrinology Diabetes and Metabolism Disease Severity of Illness Index Diabetic Ketoacidosis Endocrinology Weight loss Pandemic Odds Ratio medicine Humans Child Retrospective Studies Type 1 diabetes Portugal SARS-CoV-2 business.industry Infant Newborn COVID-19 Infant Retrospective cohort study Emergency department medicine.disease Ketoacidosis Diabetes Mellitus Type 1 Child Preschool Relative risk Pediatrics Perinatology and Child Health Female medicine.symptom business |
| Zdroj: | Journal of Pediatric Endocrinology and Metabolism. 35:73-77 |
| ISSN: | 2191-0251 0334-018X |
| Popis: | Objectives Since the beginning of the COVID-19 pandemic, there has been a consistent decrease in the number of admissions to the emergency department, leading to a delay in the diagnosis of several pathologies. The time from onset of symptoms to the diagnosis of Type 1 diabetes is highly variable. This treatment delay can lead to the appearance of ketoacidosis. Methods Retrospective study of inaugural Type 1 diabetes cases, from March 2016 to March 2021. The pandemic group was considered between March 2020 to March 2021, and the remaining period was considered as pre-pandemic. Clinical variables were analysed: duration of symptoms, weight loss and value of ketonemia and glycated haemoglobin on admission. The mean differences were considered statistically significant at p Results 103 inaugural episodes of Type 1 diabetes were registered. The pandemic group had a lower mean age when compared to pre-pandemic group, and 51.7% of the episodes had ketoacidosis with a higher relative risk of ketoacidosis and severe ketoacidosis, when compared the pandemic with pre-pandemic group, there was a longer symptom evolution time (34 vs. 20 days), greater weight loss occurred (9.5% vs. 6.3%), the pH and HCO3 − values were lower (7.30 vs. 7.36 and 16.43 vs. 20.71 mmol/L respectively) and ketonemia was higher (5.9 vs. 2.3 mmol/L). Conclusions The COVID-19 pandemic caused a delay in the diagnosis of Type 1 diabetes, greater length of disease, greater weight loss, higher ketonemia and lower pH and HCO3 −. There was greater ketoacidosis relative risk in pandemic group when compared to pre-pandemic group. |
| Databáze: | OpenAIRE |
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