SARS-CoV-2 Infection and Development of Islet Autoimmunity in Early Childhood-Reference-Cited by-同舟云学术

SARS-CoV-2 Infection and Development of Islet Autoimmunity in Early Childhood

Published:2023-09-26 Issue:12 Volume:330 Page:1151
ISSN:0098-7484
Container-title:JAMA
language:en
Short-container-title:JAMA

Author:

Lugar Marija¹,Eugster Anne¹,Achenbach Peter²³⁴,von dem Berge Thekla⁵,Berner Reinhard⁶,Besser Rachel E. J.⁷⁸,Casteels Kristina⁹¹⁰,Elding Larsson Helena¹¹¹²,Gemulla Gita¹⁶,Kordonouri Olga⁵,Lindner Annett¹,Lundgren Markus¹¹¹³,Müller Denise¹,Oltarzewski Mariusz¹⁴,Rochtus Anne⁹¹⁰,Scholz Marlon²³⁴,Szypowska Agnieszka¹⁵,Todd John A.⁸,Ziegler Anette-Gabriele²³⁴,Bonifacio Ezio¹¹⁶¹⁷,Gündert Melanie¹⁸,Haupt Florian¹⁸,Arnolds Stefanie¹⁸,Blasius Karina¹⁸,Friedl Nadine¹⁸,Gezginci Cigdem¹⁸,Göppel Gertrud¹⁸,Heigermoser Martin¹⁸,Hergl Maja¹⁸,Höfelschweiger Bianca¹⁸,Jolink Manja¹⁸,Kisfügedi Krisztian¹⁸,Klein Nadine¹⁸,Matzke Claudia¹⁸,Niewöhner Rebecca¹⁸,Schütte-Borkovec Katharina¹⁸,Weiß Andreas¹⁸,Zapardiel Gonzalo José Maria¹⁸,Schmidt Sarah¹⁸,Vurucu Merve¹⁸,Sarcletti Katharina¹⁸,Sporreiter Melanie¹⁸,Jacobson Stefanie¹⁸,Janssen Charlien¹⁸,Morobé Hilde¹⁸,Vrancken Brontë¹⁸,Van den Driessche Natalie¹⁸,Van Poel Gert¹⁸,Van Heyste Renka¹⁸,Houben Janne¹⁸,Vanhuyse Veerle¹⁸,Arabi Sari¹⁸,Barbknecht Lisa¹⁸,Dietz Sevina¹⁸,Ehrlich Franziska¹⁸,Gholizadeh Zahra¹⁸,Hoffmann Raphael¹⁸,Hommel Angela¹⁸,Lange Franziska¹⁸,Loff Anja¹⁸,Morgenstern Robert¹⁸,Schille Anne¹⁸,Sigg Maike¹⁸,Weigelt Marc¹⁸,Weise Andre¹⁸,Zubizarreta Nicole¹⁸,Danne Thomas¹⁸,Galuschka Laura¹⁸,Kruse Carolin¹⁸,Landsberg Sarah¹⁸,Lange Karin¹⁸,Marquardt Erika¹⁸,Reschke Felix¹⁸,Roloff Frank¹⁸,Weiskorn Jantje¹⁸,Polier Mareike¹⁸,Schmidt Bianca¹⁸,Bunk Melanie¹⁸,Hofelich Anna¹⁸,Huber Elisabeth¹⁸,Kaiser Melina¹⁸,Käßl Alexandra¹⁸,Marcus Benjamin¹⁸,Munzinger Annette¹⁸,Ramminger Claudia¹⁸,Reinmüller Franziska¹⁸,Vollmuth Veronika¹⁸,Winkler Christiane¹⁸,Dybkowska Sylwia¹⁸,Groele Lidia¹⁸,Owczarek Dorota¹⁸,Popko Katarzyna¹⁸,Cieloch Adrianna¹⁸,Dzygalo Katarzyna¹⁸,Górska Elżbieta¹⁸,Mroczek Agnieszka¹⁸,Zduńczyk Beata¹⁸,Zych Anna¹⁸,Czerwińska Wiktoria¹⁸,Dziedzic Natalia¹⁸,Samuelsson Hanna¹⁸,Alström Mortin Sofie¹⁸,Bennet Rasmus¹⁸,Brundin Charlotte¹⁸,Dahlberg Susanne¹⁸,Fransson Lina¹⁸,Jönsson Ida¹⁸,Nenonen Hannah¹⁸,Ramelius Anita¹⁸,Törn Carina¹⁸,Ulvenhag Ulrika¹⁸,Lindström Marielle¹⁸,Rhamati Kobra¹⁸,Goldman Tsubarah Malin¹⁸,Salami Falastin¹⁸,Hawkins Sophia¹⁸,Mujadidi Yama F¹⁸,Smith Ian¹⁸,Roseman Fenella¹⁸,Robinson Hannah¹⁸,Taj Nazia¹⁸,Whelan Conor¹⁸,Wishlade Tabitha¹⁸,Vernon Sophie¹⁸,Ratcliffe Helen¹⁸,

Affiliation:

1. Technische Universität Dresden, Center for Regenerative Therapies Dresden, Dresden, Germany

2. Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany

3. Forschergruppe Diabetes, School of Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany

4. Forschergruppe Diabetes e.V. at Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany

5. Kinder-und Jugendkrankenhaus AUF DER BULT, Hannover, Germany

6. Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

7. Department of Pediatrics, University of Oxford, Oxford, United Kingdom

8. Wellcome Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, Oxford University, Oxford, United Kingdom

9. Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium

10. Department of Development and Regeneration, KU Leuven, Leuven, Belgium

11. Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden

12. Department of Paediatrics, Skåne University Hospital, Malmö, Sweden

13. Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden

14. Institute of Mother and Child, Warsaw, Poland

15. Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland

16. Paul Langerhans Institute Dresden of the Helmholtz Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Germany

17. Institute for Diabetes and Obesity, Helmholtz Munich, German Center for Environmental Health, Munich, Germany

18. for the GPPAD Study Group

Abstract

ImportanceThe incidence of diabetes in childhood has increased during the COVID-19 pandemic. Elucidating whether SARS-CoV-2 infection is associated with islet autoimmunity, which precedes type 1 diabetes onset, is relevant to disease etiology and future childhood diabetes trends.ObjectiveTo determine whether there is a temporal relationship between SARS-CoV-2 infection and the development of islet autoimmunity in early childhood.Design, Setting, and ParticipantsBetween February 2018 and March 2021, the Primary Oral Insulin Trial, a European multicenter study, enrolled 1050 infants (517 girls) aged 4 to 7 months with a more than 10% genetically defined risk of type 1 diabetes. Children were followed up through September 2022.ExposureSARS-CoV-2 infection identified by SARS-CoV-2 antibody development in follow-up visits conducted at 2- to 6-month intervals until age 2 years from April 2018 through June 2022.Main Outcomes and MeasuresThe development of multiple (≥2) islet autoantibodies in follow-up in consecutive samples or single islet antibodies and type 1 diabetes. Antibody incidence rates and risk of developing islet autoantibodies were analyzed.ResultsConsent was obtained for 885 (441 girls) children who were included in follow-up antibody measurements from age 6 months. SARS-CoV-2 antibodies developed in 170 children at a median age of 18 months (range, 6-25 months). Islet autoantibodies developed in 60 children. Six of these children tested positive for islet autoantibodies at the same time as they tested positive for SARS-CoV-2 antibodies and 6 at the visit after having tested positive for SARS-CoV-2 antibodies. The sex-, age-, and country-adjusted hazard ratio for developing islet autoantibodies when the children tested positive for SARS-CoV-2 antibodies was 3.5 (95% CI, 1.6-7.7; P = .002). The incidence rate of islet autoantibodies was 3.5 (95% CI, 2.2-5.1) per 100 person-years in children without SARS-CoV-2 antibodies and 7.8 (95% CI, 5.3-19.0) per 100 person-years in children with SARS-CoV-2 antibodies (P = .02). Islet autoantibody risk in children with SARS-CoV-2 antibodies was associated with younger age (&lt;18 months) of SARS-CoV-2 antibody development (HR, 5.3; 95% CI, 1.5-18.3; P = .009).Conclusion and relevanceIn young children with high genetic risk of type 1 diabetes, SARS-CoV-2 infection was temporally associated with the development of islet autoantibodies.

Publisher

American Medical Association (AMA)

Subject

General Medicine

Link

https://jamanetwork.com/journals/jama/articlepdf/2809621/jama_lugar_2023_oi_230100_1695046175.41487.pdf

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