Abstract
Background and Objective: It is known that several viruses are involved in the pathogenesis of type 1 diabetes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new worldwide spread virus that may act as a trigger for the autoimmune destruction of the β-cells, as well, and thus lead to an increase in the incidence of type 1 diabetes. Material and Methods: The Romanian National Organization for the Protection of Children and Adolescents with Diabetes (ONROCAD) has collected information regarding new cases of type 1 diabetes in children aged 0 to 14 years from all over the country since 1996 and has computed the incidence of type 1 diabetes in this age group. Results: We observed a marked increase in the incidence of type 1 diabetes in the first year of the COVID-19 pandemic, with 16.9%, from 11.4/100,000 in 2019 to 13.3/100,000 in 2020, much higher compared to previous years (mean yearly increase was 5.1% in the period 1996–2015 and 0.8% in the interval 2015–2019). The proportion of newly diagnosed cases was significantly higher in the second half of 2020 compared to the second half of the previous years (57.8 vs. 51%, p < 0.0001). Conclusions: All these aspects suggest the role that SARS-CoV-2 could have in triggering pancreatic autoimmunity. To confirm this, however, collecting information from larger populations from different geographical regions, monitoring the incidence curves over a period of several years, and gathering background information on COVID-19 and/or data on COVID-19 specific antibodies are needed.
Highlights
It is well known that in most cases, type 1 diabetes is an autoimmune disorder
We observed a marked increase in the incidence of type 1 diabetes in the first year of the COVID-19 pandemic, with 16.9%, from 11.4/100,000 in 2019 to 13.3/100,000 in 2020, much higher compared to previous years
Several papers regarding the incidence of type 1 diabetes in children from this country have been published, showing that the incidence is growing steadily, at a faster pace than in other countries in Europe, and that there is a seasonality of new cases, the maximum incidence being registered in January, and the minimum in June [11,12,13]
Summary
It is well known that in most cases, type 1 diabetes is an autoimmune disorder. The theory regarding its pathogenesis states that in individuals with a permissive genetic background, various environmental factors (infectious, dietary, etc.) act as triggers for autoimmunity and lead, in time, to the partial or total destruction of the pancreatic β-cells and, as a consequence, to insulin deficiency. As well as at the onset of the disease, some pancreatic antibodies may be detected in the patients’ serum, being markers of pancreatic autoimmunity [1]. This theory has a solid scientific background, until now it did not lead to the development of an effective method for the prevention of type 1 diabetes, despite numerous attempts. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new worldwide spread virus that may act as a trigger for the autoimmune destruction of the β-cells, as well, and lead to an increase in the incidence of type 1 diabetes. To confirm this collecting information from larger populations from different geographical regions, monitoring the incidence curves over a period of several years, and gathering background information on COVID-19 and/or data on COVID-19 specific antibodies are needed
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