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Lee NW, Kim YM, Kim YH, Kang SJ, Jang KM, Kim HS, Moon JE, Kim JK. Clinical characteristics and outcomes of COVID-19 in children and adolescents with diabetes in Daegu, South Korea. Ann Pediatr Endocrinol Metab 2024; 29:167-173. [PMID: 38956753 PMCID: PMC11220390 DOI: 10.6065/apem.2346124.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/19/2023] [Accepted: 11/14/2023] [Indexed: 07/04/2024] Open
Abstract
PURPOSE Children with comorbidities have a higher risk of severe, coronavirus disease 2019 (COVID-19). This study investigated the clinical features and outcomes of COVID-19 in children and adolescents with diabetes between January and March 2022. METHODS We retrospectively reviewed the medical records of 123 children and adolescents (73 with type 1 diabetes and 50 with type 2 diabetes, 59 males and 64 females) aged <18 years who had been diagnosed with diabetes. Data were collected from 7 academic medical centers in Daegu, South Korea. RESULTS Thirty-five children with diabetes were diagnosed with COVID-19 (18 with type 1 and 17 with type 2 diabetes). Eighteen of the 35 children with diabetes and COVID-19 and 50 of the 88 children with diabetes alone received a COVID-19 vaccination. No significant differences were observed between patients with diabetes and COVID-19 and patients with diabetes alone in the type of diabetes diagnosed, sex, age, body mass index, hemoglobin A1c, or vaccination status. All children with diabetes and COVID-19 had mild clinical features and were safely managed in their homes. Fourteen children had a fever of 38℃ or higher that lasted for more than 2 days, 11 of whom were not vaccinated (p=0.004). None experienced post-COVID-19 conditions. CONCLUSION All children and adolescents with pre-existing diabetes had mild symptoms of COVID-19 due to low disease severity, high vaccination rates, uninterrupted access to medical care, and continuous glucose monitoring. Unvaccinated children with diabetes who experienced COVID-19 presented with higher and more frequent fevers compared to vaccinated children.
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Affiliation(s)
- Na-Won Lee
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - You-Min Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Young-Hwan Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Seok-Jin Kang
- Department of Pediatrics, Keimyung University Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Kyung-Mi Jang
- Department of Pediatrics, Yeungnam University Hospital, Yeungnam University School of Medicine, Daegu, Korea
| | - Hae-Sook Kim
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
| | - Jung-Eun Moon
- Department of Pediatrics, Kyungpook University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jin-Kyung Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
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Han JW, Kim JM, Lee H. Topic Modeling-Based Analysis of News Keywords Related to Patients with Diabetes during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11070957. [PMID: 37046886 PMCID: PMC10094025 DOI: 10.3390/healthcare11070957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
This study analyzed major issues related to diabetes during the coronavirus disease (COVID-19) pandemic by using topic modeling analysis of online news articles provided by BIGKind dating from 20 January 2020, the onset of the COVID-19 outbreak in Korea, to 17 April 2022, the lifting of the social distancing restrictions. We selected 226 articles and conducted topic modeling analysis to identify the main agenda of news related to patients with diabetes in the context of the COVID-19 pandemic; both latent Dirichlet allocation and visualization were conducted by generating keywords extracted from news text as a matrix using Python 3.0. Four main topics were extracted from the news articles related to “COVID-19” and “diabetes” during the COVID-19 pandemic, including “COVID-19 high-risk group,” “health management through digital healthcare,” “risk of metabolic disease related to quarantine policy,” and “child and adolescent obesity and diabetes.” This study is significant because it uses big data related to diabetes that was reported in the mass media during the new epidemic to identify problems in the health management of patients with diabetes during a new epidemic and discuss areas that should be considered for future interventions.
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Oh KE, Kim YJ, Oh YR, Kang E, Nam HK, Rhie YJ, Lee KH. Commentary on "The prevalence of diabetic peripheral neuropathy in youth with diabetes mellitus". Ann Pediatr Endocrinol Metab 2023; 28:275-282. [PMID: 37015773 PMCID: PMC10765022 DOI: 10.6065/apem.2244214.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/10/2022] [Accepted: 02/16/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on type 2 diabetes mellitus (T2DM) in children and adolescents. Methods Children and adolescents diagnosed with T2DM who visited the Korea University Hospital in 2019 and 2020 were retrospectively analyzed, including changes in body mass index (BMI)-standard deviation score (SDS), glycated hemoglobin (HbA1c), diabetes complications, and diabetes management from 2019 to 2020. Results Patient mean age and disease duration were 15.48±2.15 and 2.56±1.51 years, respectively. Obese patients accounted for 70.6% of the study population. From 2019 to 2020, mean BMI-SDS (2.21±1.25 vs. 2.35±1.43, P =0.044), HbA1c level (6.5%±2.72% vs. 7.3%±3.70%, P <0.001), blood pressure (BP), total cholesterol, and non–high-density lipoprotein cholesterol level in all patients increased significantly. Obesity was an independent predictor of increased HbA1c (95% confidence interval, 1.071–50.384; P =0.042). HbA1c levels did not increase significantly in nonobese patients, whereas HbA1c (6.45%±2.30% vs. 7.20%±3.05%, P <0.001), BMI-SDS (2.88±0.75 vs. 3.08±0.98, P =0.045), diastolic BP (P =0.037), and total cholesterol values (P =0.019) increased in obese patients in 2020 compared to 2019. Conclusions During the COVID-19 outbreak, glycemic control and diabetic complications worsened in children and adolescents with T2DM, particularly in obese patients. Close monitoring for glycemic control and diabetic complications is necessary in children and adolescents with T2DM, especially those with obesity.
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Affiliation(s)
- Kyeong Eun Oh
- Department of Pediatrics, Woori Children’s Hospital, Seoul, Korea
| | - Yu Jin Kim
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Ye Rim Oh
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Eungu Kang
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, Korea University Kuro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Chioma L, Chiarito M, Bottaro G, Paone L, Todisco T, Bizzarri C, Cappa M. COVID-19 pandemic phases and female precocious puberty: The experience of the past 4 years (2019 through 2022) in an Italian tertiary center. Front Endocrinol (Lausanne) 2023; 14:1132769. [PMID: 36926039 PMCID: PMC10011474 DOI: 10.3389/fendo.2023.1132769] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE Since the outbreak of COVID-19 pandemic, several centers of pediatric endocrinology worldwide have observed a significant increase in the number of girls presenting with precocious or early puberty. We aimed to compare the incidence rates of female precocious puberty before and during the different phases of COVID-19 pandemic. METHODS We have retrospectively analyzed all the consultations recorded in the outpatient clinic database of the Endocrinology Unit of Bambino Gesù Children's Hospital, Rome, Italy, from the lockdown start in March 2020 up to September 2020, in comparison with the consultations recorded in the same months of 2019, 2021 and 2022. Age, height, weight, body mass index, Tanner's pubertal stage and bone age at presentation, birth weight, ethnicity, family history of central precocious puberty (CPP), maternal age at menarche, history of adoption were retrieved from clinical records. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH) both at baseline and after gonadotropin-releasing hormone (GnRH) stimulation, and basal estradiol levels were collected. RESULTS In 2019, 78 girls with suspected precocious puberty were referred for endocrinological consultation, compared to 202 girls in 2020, 158 girls in 2021 and 112 girls in 2022. A significant increase in the proportion of girls diagnosed with rapidly progressive CPP was observed in 2020, compared to 2019 (86/202 vs. 18/78, p<0.01). In the following periods of 2021 and 2022, a gradual decrease in the number of cases of progressive CPP was evident, so much that the number of cases was not significantly different from that observed in 2019 (56/158 in 2021 and 35/112 in 2022, p=0.054 and p=0.216 respectively, compared to 2019). CONCLUSIONS Our research suggests that drastic lifestyle changes, such as those imposed by COVID-19 lockdown, and the consequent stress may affect the regulation of pubertal timing. The remarkable increase in CPP cases observed during the 2020 first pandemic wave seems to be reduced in 2021 and 2022, concurrently with the progressive resumption of daily activities. These data seem to support the hypothesis of a direct relationship between profound life-style changes related to the pandemic and the rise in precocious puberty cases.
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Park HK, Seo JY, Jung HW, Lim JS. Prevalence and trends in obesity and severe obesity in Korean children and adolescents, 2007-2020: A population-based study. Pediatr Int 2023; 65:e15472. [PMID: 36645370 DOI: 10.1111/ped.15472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/05/2022] [Accepted: 12/27/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND The age-adjusted prevalence of child and adolescent obesity has been stabilized in the Korean population, although severe obesity has increased with adverse health effects. In this study, we detailed the prevalence of and trends in overweight, obesity, and severe obesity in Korean children and adolescents by age group and sex from a nationally representative sample, using a new, 2017 age- and sex-specific reference for body mass index. METHODS We collected Korea National Health and Nutrition Examination Survey data from the years 2007-2020. A total of 23,595 subjects (11,210 females) aged 2-18 years were included in this study. We calculated the recent prevalence of overweight and obesity, including severe obesity, by weighted data from 2019 and 2020. RESULTS The prevalence of overweight and obesity (class II and class III obesity) was 23.5% and 14.2% (2.5% and 0.5%), respectively. Males showed a higher prevalence of overweight and obesity. Adolescents aged 13-15 years showed the highest prevalence of severe obesity. A positive linear trend was significant for overweight (p = 0.025), class I obesity (p < 0.001), and class II obesity (p = 0.002) for both sexes and all ages combined. However, the trend of obesity prevalence was different in each subgroup. Comparing pre- and post- COVID-19 pandemic, obesity prevalence seemed to increase, but not significantly. CONCLUSIONS Despite previous reports that obesity in children and adolescents has remained stable, we found that the prevalence of overweight, obesity, and severe obesity has increased in Korean children and adolescents. The effects of COVID-19 on this trend require further evaluation.
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Affiliation(s)
- Hong Kyu Park
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Ji-Young Seo
- Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea
| | - Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul, South Korea
| | - Jung Sub Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, South Korea
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Street ME, Ponzi D, Renati R, Petraroli M, D’Alvano T, Lattanzi C, Ferrari V, Rollo D, Stagi S. Precocious puberty under stressful conditions: new understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic. Front Endocrinol (Lausanne) 2023; 14:1149417. [PMID: 37201098 PMCID: PMC10187034 DOI: 10.3389/fendo.2023.1149417] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/06/2023] [Indexed: 05/20/2023] Open
Abstract
Neuro-biological variations in the timing of sexual maturation within a species are part of an evolved strategy that depend on internal and external environmental conditions. An increased incidence of central precocious puberty (CPP) has been described in both adopted and "covid-19 pandemic" children. Until recently, it was hypothesised that the triggers for CPP in internationally adopted children were likely to be better nutrition, greater environmental stability, and improved psychological wellbeing. However, following data collected during and after the coronavirus (COVID-19) global pandemic, other possibilities must be considered. In a society with high levels of child wellbeing, the threat to life presented by an unknown and potentially serious disease and the stressful environment created by lockdowns and other public health measures could trigger earlier pubertal maturation as an evolutionary response to favour early reproduction. The main driver for increased rates of precocious and rapidly progressive puberty during the pandemic could have been the environment of "fear and stress" in schools and households. In many children, CPP may have been triggered by the psychological effects of living without normal social contact, using PPE, being near adults concerned about financial and other issues and the fear of getting ill. The features and time of progression of CPP in children during the pandemic are similar to those observed in adopted children. This review considers the mechanisms regulating puberty with a focus on neurobiological and evolutionary mechanisms, and analyses precocious puberty both during the pandemic and in internationally adopted children searching for common yet unconsidered factors in an attempt to identify the factors which may have acted as triggers. In particular, we focus on stress as a potential factor in the early activation of the hypothalamic-pituitary-gonadal axis and its correlation with rapid sexual maturation.
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Affiliation(s)
- Maria Elisabeth Street
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Unit of Paediatrics, P. Barilla Children’s Hospital, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
- *Correspondence: Maria Elisabeth Street,
| | - Davide Ponzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Renati
- Department of Pedagogy, Psychology and Philosophy, University of Cagliari, Cagliari, Italy
| | - Maddalena Petraroli
- Unit of Paediatrics, P. Barilla Children’s Hospital, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Tiziana D’Alvano
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Unit of Paediatrics, P. Barilla Children’s Hospital, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Claudia Lattanzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Unit of Paediatrics, P. Barilla Children’s Hospital, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Vittorio Ferrari
- Health Sciences Department, University of Florence, Florence, Italy
| | - Dolores Rollo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Stefano Stagi
- Health Sciences Department, University of Florence, Florence, Italy
- Azienda Ospedaliero Univesitaria Meyer IRCCS, Florence, Italy
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Choi KH, Park SC. An increasing tendency of precocious puberty among Korean children from the perspective of COVID-19 pandemic effect. Front Pediatr 2022; 10:968511. [PMID: 36090560 PMCID: PMC9454605 DOI: 10.3389/fped.2022.968511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/03/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION This study was conducted to investigate changes and new trends over the past 6 years by analyzing the current status of precocious puberty (PP) treatment and treatment costs in Korea between 2016 and 2021. MATERIALS AND METHODS Annual and monthly number of patients diagnosed with PP from 2016 to 2021 were reviewed using the data from Healthcare Bigdata Hub. Annual medical insurance expenses for the treatment of PP were also reviewed. The data were compared by the gender of the patients. RESULTS The number of patients diagnosed with PP rose from 86,352 in 2016 to 166,645 in 2021, while medical expenses rose from KRW 64,111,689,000 in 2016 to KRW 134,642,100,000 in 2021. The percentage of male PP patients increased from 9.21% in 2016 to 19.55% in 2021. CONCLUSION Increasing numbers of Korean patients diagnosed with PP. Consistent with the situation in other countries, the rapid increase in the number of cases since April 2020 appears to be a result of the COVID-19 pandemic. In Korea, this is considered a nationwide phenomenon. Also on the rise is the incidence of PP in males, which appears to be due to an increased awareness of the phenomenon. Further investigations are required to determine the possible causes in increasing prevalence of PP.
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