Division of Pediatric Endocrinology, Hospital Sant Joan de Déu, Barcelona, Spain.
Division of Pediatric Diabetology, Department of Women's and Children's Health, G. Salesi Children's Hospital, Azienda Ospedaliero - Universitaria Ospedali Riuniti, Ancona, Italy.
Pediatr Diabetes. 2021 Mar;22(2):202-206. doi: 10.1111/pedi.13158. Epub 2020 Nov 26.
The severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), responsible for the coronavirus disease COVID-19, was first identified in Wuhan, China in December 2019. Diabetes, as well as other cardiovascular comorbidities, has been recognized as a major risk factor for outcomes and mortality in adults with COVID-19, particularly in the elderly with type 2 diabetes. Based on these conclusions, COVID-19 data on adults have been generalized to youth with diabetes. Nevertheless, experience from pediatric diabetes practices in China (Wuhan), Italy, Spain (Catalonia), and the United States (San Francisco Bay Area) consistently report only a single severe case of COVID-19 in a 20-year-old female youth with type 1 diabetes (T1D) that was hospitalized for bilateral pneumonia and was subsequently discharged without complications. In Italy, information on COVID-19 in all children with diabetes is collected on a weekly basis and those with positive swab test or infection-related symptoms reported to a dedicated national registry. Of a total of 15 500 children tested, 11 subjects with T1D (age 8-17y) tested positive for COVID-19; 6/11 were asymptomatic and the rest presented with mild symptoms. In the rest of locations, youths with T1D diagnosed with COVID-19 were based on clinical suspicion and a confirmatory PCR test (Wuhan:0; Catalonia-HSJD:3; California-Stanford:2). All of them were asymptomatic or had a mild course. We suggest that COVID-19 data from adults should not be generalized to children, adolescents, and youth with diabetes as their outcomes and prognosis seem to be similar to their non-diabetic-peers and consistently milder than adults with diabetes.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是导致冠状病毒病 COVID-19 的病原体,于 2019 年 12 月在中国武汉首次被发现。糖尿病以及其他心血管合并症已被确认为 COVID-19 成年患者结局和死亡率的主要危险因素,尤其是老年 2 型糖尿病患者。基于这些结论,COVID-19 成年患者的数据被推广到患有糖尿病的青少年身上。然而,中国(武汉)、意大利、西班牙(加泰罗尼亚)和美国(旧金山湾区)的儿科糖尿病实践经验一致表明,仅有一例 COVID-19 重症病例发生在一位 20 岁的 1 型糖尿病(T1D)女性青年身上,该患者因双侧肺炎住院,随后无并发症出院。在意大利,每周都会收集所有患有糖尿病的儿童的 COVID-19 信息,对于新冠病毒拭子检测阳性或有感染相关症状的患者,会向专门的国家登记处报告。在总共接受测试的 15500 名儿童中,有 11 名 T1D 患者(年龄 8-17 岁)新冠病毒检测呈阳性;6/11 例无症状,其余表现为轻症。在其他地方,根据临床怀疑和确认性 PCR 检测诊断为 COVID-19 的 T1D 青少年患者(武汉:0;加泰罗尼亚-HSJD:3;加利福尼亚州斯坦福:2)。他们均为无症状或轻症。我们建议,COVID-19 成年患者的数据不应推广到患有糖尿病的儿童、青少年和青年身上,因为他们的结局和预后似乎与非糖尿病同龄人相似,且比成年糖尿病患者更轻。