ABSTRACT
Background: CDC (Centers for Disease Control and Prevention) reported an increased risk of newly diagnosed diabetes over 30 days after SARS-CoV-2 infection among persons aged < 18 years. Similarly, the results from the DPV Registry demonstrated a significant increase in the incidence of pediatric Type 1 Diabetes during COVID-19 pandemic. The underlying mechanisms are not yet elucidated. Aim(s): To investigate the incidence of type 1 diabetes in children and adolescents during COVID-19 pandemic compared with previous 5 years Methods and Results: We conducted a retrospective study in a cohort of new onset type 1 diabetes at Bambino Gesu Children's Hospital. In 2021 as a whole we report an increase in incidence of Type 1 Diabetes compared to the years 2017 to 2020: in particular the newly diagnosed cases from 2017 to 2021 were 89 (2017), 102 (2018), 99 (2019), 99 (2020) and 121 (2021) with an increase in 2021 compared to 2017 and 2018-2020 respectively of 35% and 22%. We observed the peak of incidence in the last four months of 2021, when the 'fourth wave' of COVID-19 peaked in Italy. Between September and December 2021 we recorded 50 new diagnoses of diabetes, which represent 41% of all new diagnoses of the year.Stratification of the newly diagnosed population by age groups showed that in the last quarter of 2021 there was a significant increased Type 1 Diabetes incidence in the age group under 12 years: in particular we observed that 88% of the new diagnosed children were younger than 12 (44 patients out of 50), that is significantly different from what we observed during the first 8 months of the year (43 patients out of 71, equal to 60 % of the sample). None of the patients reported previous symptoms of COVID-19 or contact with infected people. Finally, 25 newly diagnosed subjects in the last quarter of 2021 underwent serological tests for the presence of anti-SARS-CoV-2 antibodies and 8 patients (32% of tested cases) were positive, suggesting a previous asymptomatic SARS-CoV-2 infection. Conclusion(s): We speculate that Sars-CoV-2 infection may have had an impact on Type 1 Diabetes incidence in children, especially in age groups not protected by vaccination. Prospective and targeted population studies are needed to consolidate this hypothesis and to verify if vaccination to Sars-CoV-2 can be considered protective in the pathogenesis of childhood Type 1 Diabetes.