Prosperi Sara, Chiarelli Francesco
Department of Pediatrics, University of Chieti, Chieti, Italy.
Ann Pediatr Endocrinol Metab. 2022 Sep;27(3):157-168. doi: 10.6065/apem.2244150.075. Epub 2022 Sep 30.
This review describes the impact of coronavirus disease 2019 (COVID-19) in children and adolescents, investigating changes in diabetes presentation during the COVID-19 pandemic, possible links between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and diabetes, and mechanisms of pancreatic β-cell destruction. Although glycemic control in individuals with already known diabetes mellitus did not worsen during the pandemic, there was a worrying increase in diabetic ketoacidosis in children with new-onset diabetes, probably due to containment measures and delayed access to emergency departments. Moreover, new evidence suggests that SARS-CoV-2 has the capacity to directly and indirectly induce pancreatic β-cell destruction, and the risk of newly diagnosed diabetes after COVID-19 increased in both children and adults. While long-term studies continue to follow children with SARS-CoV-2 infection, this review discusses available findings on the relationship between COVID-19 and diabetes. It is important to emphasize the need to maintain close links between families of children with chronic conditions and their pediatricians, as well as to promote early access to healthcare services, in order to reduce dangerous delays in diabetes diagnosis and prevent diabetic ketoacidosis.
本综述描述了2019冠状病毒病(COVID-19)对儿童和青少年的影响,调查了COVID-19大流行期间糖尿病表现的变化、严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染与糖尿病之间的可能联系以及胰腺β细胞破坏的机制。尽管在大流行期间,已知糖尿病患者的血糖控制并未恶化,但新发病糖尿病儿童的糖尿病酮症酸中毒却令人担忧地增加,这可能是由于防控措施以及前往急诊科就诊延迟所致。此外,新证据表明,SARS-CoV-2有能力直接和间接诱导胰腺β细胞破坏,COVID-19后新诊断糖尿病的风险在儿童和成人中均有所增加。在长期研究继续追踪感染SARS-CoV-2的儿童的同时,本综述讨论了关于COVID-19与糖尿病之间关系的现有研究结果。必须强调的是,慢性病患儿家庭与其儿科医生之间需要保持密切联系,同时促进早期获得医疗服务,以减少糖尿病诊断的危险延误并预防糖尿病酮症酸中毒。