COVID-19 infection and inactivated vaccination:Impacts on clinical and immunological profiles in Chinese children with type 1 diabetes  

作　　者：Zhen-Ran Xu Li Xi Jing Wu Jin-Wen Ni Fei-Hong Luo Miao-Ying Zhang 

机构地区：[1]Department of Pediatric Endocrinology and Inherited Metabolic Diseases,National Children’s Medical Center,Children's Hospital of Fudan University,Shanghai 201102,China

出　　处：《World Journal of Diabetes》2024年第12期2276-2284,共9页世界糖尿病杂志（英文）

基　　金：Supported by National Key Research and Development Program of China,No.2021YFC2701900 and No.2016YFC1305300.

摘　　要：BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has been linked to an increased incidence of diabetes and diabetic ketoacidosis(DKA).However,the relationship between COVID-19 infection and progression to type 1 diabetes(T1D)in children has not been well defined.AIM To evaluate the influence of COVID-19 infection and inactivated vaccine adminis-tration on the progression of T1D among Chinese children.METHODS A total of 197 newly diagnosed patients with T1D were retrospectively enrolled from Children's Hospital of Fudan University between September 2020 and December 2023.The patients were divided into three groups based on their history of COVID-19 infection and vaccination:the infection group,the vacci-nation-only group,and the non-infection/non-vaccination group.Comprehensive clinical assessments and detailed immunological evaluations were performed to delineate the characteristics and immune responses of these groups.RESULTS The incidence of DKA was significantly higher in the COVID-19 infection group(70.2%)compared to the non-infection/non-vaccination group(62.5%)and vac-scination-only group(45.6%;P=0.015).Prior COVID-19 infection was correlated with increased DKA risk(OR:1.981,95%CI:1.026-3.825,P=0.042),while vacci-nation was associated with a reduced risk(OR:0.558,95%CI:0.312-0.998,P=0.049).COVID-19 infection mildly altered immune profiles,with modest dif-ferences in autoantibody positivity,lymphocyte distribution,and immunoglobulin levels.Notably,HLA-DR3 po-sitive children with a history of COVID-19 infection had an earlier T1D onset and lower fasting C-peptide levels than the HLA-DR3 negative children with a history of infection(both P<0.05).CONCLUSION COVID-19 infection predisposes children to severe T1D,characterized by enhanced DKA risk.Inactivated vaccination significantly lowers DKA incidence at T1D onset.These findings are valuable for guiding future vaccination and T1D risk surveillance strategies in epidemic scenarios in the general pediatric population.

关 键 词：COVID-19 infection Diabetic ketoacidosis Type 1 diabetes VACCINATION Immune profiles 

分 类 号：R725.8[医药卫生—儿科]