Infection episodes and islet autoantibodies in children at increased risk for type 1 diabetes before and during the COVID-19 pandemic.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2024-12-01 Epub Date: 2024-06-14 DOI:10.1007/s15010-024-02312-y

Ivo Zeller, Andreas Weiss, Stefanie Arnolds, Katharina Schütte-Borkovec, Sari Arabi, Thekla von dem Berge, Kristina Casteels, Angela Hommel, Olga Kordonouri, Helena Elding Larsson, Markus Lundgren, Anne Rochtus, Matthew D Snape, Agnieszka Szypowka, Manu Vatish, Christiane Winkler, Ezio Bonifacio, Anette-Gabriele Ziegler

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引用次数: 0

Abstract

Objectives: To determine the impact of the COVID-19 pandemic on the incidence rates of infection and islet autoimmunity in children at risk for type 1 diabetes.

Methods: 1050 children aged 4 to 7 months with an elevated genetic risk for type 1 diabetes were recruited from Germany, Poland, Sweden, Belgium and the UK. Reported infection episodes and islet autoantibody development were monitored until age 40 months from February 2018 to February 2023.

Results: The overall infection rate was 311 (95% Confidence Interval [CI], 304-318) per 100 person years. Infection rates differed by age, country, family history of type 1 diabetes, and period relative to the pandemic. Total infection rates were 321 per 100 person-years (95% CI 304-338) in the pre-pandemic period (until February 2020), 160 (95% CI 148-173) per 100 person-years in the first pandemic year (March 2020-February 2021; P < 0.001) and 337 (95% CI 315-363) per 100 person-years in subsequent years. Similar trends were observed for respiratory and gastrointestinal infections. Islet autoantibody incidence rates were 1.6 (95% CI 1.0-2.4) per 100 person-years in the pre-pandemic period, 1.2 (95% CI 0.8-1.9) per 100 person-years in the first pandemic year (P = 0.46), and 3.4 (95% CI 2.3-4.8) per 100 person-years in subsequent years (P = 0.005 vs. pre-pandemic year; P < 0.001 vs. first pandemic year).

Conclusions: The COVID-19 pandemic was associated with significantly altered infection patterns. Islet autoantibody incidence rates increased two-fold when infection rates returned to pre-pandemic levels.

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在 COVID-19 大流行之前和期间，1 型糖尿病高危儿童的感染发作和胰岛自身抗体。

目的方法：从德国、波兰、瑞典、比利时和英国招募 1050 名 4 至 7 个月大的 1 型糖尿病遗传风险较高的儿童。从2018年2月至2023年2月，对报告的感染发作和胰岛自身抗体发展情况进行监测，直至40个月大：总感染率为每 100 人年 311 例（95% 置信区间 [CI]，304-318 例）。感染率因年龄、国家、1型糖尿病家族史和大流行时期而异。大流行前（至 2020 年 2 月）的总感染率为每 100 人年 321 例（95% CI 304-338），大流行第一年（2020 年 3 月至 2021 年 2 月；P 结论）为每 100 人年 160 例（95% CI 148-173）：COVID-19 大流行与感染模式的显著改变有关。当感染率恢复到大流行前的水平时，胰岛自身抗体发病率增加了两倍。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.