METHODS: This is a prospective observational study of all children under age 14 years newly diagnosed with T1D in Kuwait. We define the duration of the COVID-19 pandemic from the official declaration of the first identified positive COVID-19 case on 24 February 2020 until 31 December 2022. For comparison, we use the time period directly before the COVID-19 pandemic, 1 January 2017 to 23 February 2020.
RESULTS: One thousand twenty-four (1024) children newly diagnosed with T1D in Kuwait during the study period were included. Among newly diagnosed children, 20.3% tested positive for thyroid antibodies during the COVID-19 pandemic, compared with 14.5% during the pre-pandemic period (p = 0.015). Children with positive COVID-19 status were more likely to present with thyroid antibodies (p = 0.035). After adjusting for other characteristics, patients diagnosed with T1D during the COVID-19 pandemic had double the odds of testing positive for thyroid antibodies (Adjusted odds ratio = 2.173, 95%CI: 1.108, 4.261, p = 0.024).
CONCLUSIONS: Incident cases of T1D during the COVID-19 pandemic may be different in aetiology or contextual factors leading to a higher risk of thyroid autoimmunity. Longitudinal studies are needed to understand the role of COVID-19 in the onset and progression of T1D and on thyroid autoimmunity and disease.
方法:这是一项对科威特所有14岁以下儿童新诊断为T1D的前瞻性观察性研究。我们定义了COVID-19大流行的持续时间,从2020年2月24日首例确认的阳性COVID-19病例的正式宣布到2022年12月31日。为了比较,我们使用COVID-19大流行之前的时间段,2017年1月1日至2020年2月23日。
结果:研究期间在科威特新诊断为T1D的一千名儿童。在新诊断的儿童中,在COVID-19大流行期间,20.3%的甲状腺抗体检测呈阳性,与大流行前的14.5%相比(p=0.015)。COVID-19状态阳性的儿童更有可能出现甲状腺抗体(p=0.035)。调整其他特性后,在COVID-19大流行期间诊断为T1D的患者的甲状腺抗体检测呈阳性的几率增加了一倍(调整后比值比=2.173,95CI:1.108,4.261,p=0.024).
结论:在COVID-19大流行期间发生T1D的病例在病因或背景因素方面可能有所不同,导致甲状腺自身免疫的风险更高。需要进行纵向研究,以了解COVID-19在T1D的发作和进展以及甲状腺自身免疫和疾病中的作用。