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Bjerregaard-Andersen M, Da Silva J, Diogo R, Claro AR, Ferro I, Romana A, Rocha P, Sá B, Lobarinhas G, Rolim S, Juhl CB, Højlund K, Fernandes I, Antunes S, Félix Calha MM, Gama G, Amálio S, Figueiras M, Silva T, Rosado M, Ferrão E, Arez L, Baptista A, Martins Ferreira A, Alba D, Godinho C, Leite AL, Afonso Lopes MDL, Sampaio ML, Serra-Caetano J, Carvalho E. Association between COVID-19 and the incidence of type 1 diabetes in Portugal - a registry study. BMC Endocr Disord 2024; 24:145. [PMID: 39123199 PMCID: PMC11313027 DOI: 10.1186/s12902-024-01667-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Viral respiratory infections may precipitate type 1 diabetes (T1D). A possible association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, and the incidence of T1D is being determined. This study was carried out using Portuguese registries, aiming at examining temporal trends between COVID-19 and T1D. METHODS Hospital data, comparing the incidence before and during the COVID-19 pandemic, from children and young adults diagnosed with new-onset T1D, was acquired beginning in 2017 and until the end of 2022. Data was obtained from nine different Portuguese hospital units. The impact of the COVID-19 pandemic, beginning in March 2020, was assessed comparing the annual numbers of new-onset T1D cases. The annual median levels of glucose, glycated hemoglobin (HbA1c) and fasting C-peptide at T1D diagnosis were compared. The annual number of diabetic ketoacidosis (DKA) episodes among new T1D cases was also assessed at two centers. RESULTS In total, data from 574 newly diagnosed T1D patients was analyzed, including 530 (92.3%) children. The mean ages for child and adult patients were 9.1 (SD 4.4) and 32.8 (SD 13.6) years, respectively. 57.8% (331/573) were male, one patient had unknown sex. The overall median (25-75 percentiles) levels of glucose, HbA1c and fasting C-peptide at diagnosis were 454 mg/dL (356-568), 11.8% (10.1-13.4) and 0.50 µg/L (0.30-0.79), respectively. DKA at T1D diagnosis was present in 48.4% (76/157). For eight centers with complete 2018 to 2021 data (all calendar months), no overall significant increase in T1D cases was observed during the COVID-19 pandemic, i.e. 90 cases in 2018, 90 cases in 2019, 112 in 2020 and 100 in 2021 (P for trend = 0.36). Two of the centers, Faro (CHUA) and Dona Estefânia (CHULC) hospitals, did however see an increase in T1D from 2019 to 2020. No significant changes in glucose (P = 0.32), HbA1c (P = 0.68), fasting C-peptide (P = 0.20) or DKA frequency (P = 0.68) at the time of T1D diagnosis were observed over the entire study period. CONCLUSION The T1D incidence did not increase significantly, when comparing the years before and during the COVID-19 pandemic, nor did key metabolic parameters or number of DKA episodes change.
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Affiliation(s)
- Morten Bjerregaard-Andersen
- Department of Endocrinology and Nephrology, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark.
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Jessica Da Silva
- Institute for Interdisciplinary Research, Doctoral Program in Experimental Biology and Biomedicine (PDBEB), University of Coimbra, Coimbra, Portugal
- CNC-UC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, 3004-504, Portugal
- CIBB - Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, 3004-504, Portugal
| | - Rui Diogo
- Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra (CHUC) E.P.E., Coimbra, Portugal
| | - Ana Raquel Claro
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHLN) E.P.E., Lisbon, Portugal
| | - Inês Ferro
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHLN) E.P.E., Lisbon, Portugal
| | - Andreia Romana
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHLN) E.P.E., Lisbon, Portugal
| | | | - Beatriz Sá
- Centro Hospitalar de Leiria E.P.E., Leiria, Portugal
| | | | - Sara Rolim
- Hospital Santa Maria Maior E.P.E., Barcelos, Portugal
| | - Claus Bogh Juhl
- Department of Endocrinology and Nephrology, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Kurt Højlund
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | | | | | | | - Guida Gama
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | - Sofia Amálio
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | - Mariana Figueiras
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | - Teresa Silva
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | - Margarida Rosado
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | - Estela Ferrão
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | - Luísa Arez
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | - Ana Baptista
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | | | - Diana Alba
- Centro Hospitalar do Tâmega e Sousa E.P.E., Guilhufe, Portugal
| | - Carlos Godinho
- Centro Hospitalar Universitário do Algarve (CHUA) E.P.E., Faro, Portugal
| | - Ana Luísa Leite
- Centro Hospitalar de Vila Nova de Gaia/Espinho (CHVNG/E) E.P.E., Vila Nova de Gaia, Portugal
| | - Maria de Lurdes Afonso Lopes
- Unidade de Endocrinologia Pediátrica, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central (CHULC) E.P.E., Lisbon, Portugal
| | - Maria Lurdes Sampaio
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHLN) E.P.E., Lisbon, Portugal
| | - Joana Serra-Caetano
- Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra (CHUC) E.P.E., Coimbra, Portugal
| | - Eugenia Carvalho
- CNC-UC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, 3004-504, Portugal
- CIBB - Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, 3004-504, Portugal
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Casa Costa Alemão, Coimbra, 3030- 789, Portugal
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Veasey JV, Elia VC, Ribeiro AE, Lellis RF. Overdosage of PPD immunotherapy causing tuberculosis-like skin lesions ⋆. An Bras Dermatol 2024; 99:629-631. [PMID: 38644070 PMCID: PMC11221158 DOI: 10.1016/j.abd.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 04/23/2024] Open
Affiliation(s)
- John Verrinder Veasey
- Dermatology Clinic, Hospital da Santa Casa de São Paulo, São Paulo, SP, Brazil; Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil.
| | | | - Ana Estela Ribeiro
- Dermatology Clinic, Hospital da Santa Casa de São Paulo, São Paulo, SP, Brazil
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