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New research has linked the coronavirus to the onset of type 1 diabetes in children.
The infection is mild in four out of five cases, young people being generally particularly resistant. A study suggests that children are half as likely to catch the virus initially, let alone become seriously ill.
However, a minority of patients develop complications after overcoming the infection, with the coronavirus being linked to everything from hearing loss to temporary brain damage.
Concerns have been raised Type 1 diabetes could be another side effect after 30 young people presented to hospitals in North West London with a new case of the disease amid the peak of the epidemic.
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This is about double the number of new incidents that have occurred during the same period over the past five years.
Although unclear, a protein on the coronavirus can attack insulin-producing cells in a patient’s pancreas, according to the study’s authors at Imperial College London.
However, not all 30 young people were tested for the pathogen, with only five showing evidence of past or current infection.
Other experts noted that the study “raises concerns” but added that the evidence was “weak”.
‘Exceptionally high’ type 1 diabetes in children amid coronavirus
“Children appear to be at low risk of developing severe cases of COVID-19 [the disease triggered by the coronavirus]However, we must consider the potential health complications from exposure to the virus in children, ”said study author Karen Logan.
Between March 23 – when the lockdown was put in place in the UK – and June 4, scientists analyzed data from five inpatient pediatric care units in four NHS North West London trusts: Imperial College Healthcare, Chelsea & Westminster, Hillingdon Hospitals and London North West University Healthcare.
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The results – published in the journal Diabetes Care – revealed an increase in type 1 cases in two of the units, which diagnosed 10 young patients each.
This is compared to an average of just two and four new incidents, respectively, in April and May over the past five years.
Diagnosis rates in the other three units, however, were similar to those in the past.
“Our analysis shows that during the peak of the pandemic, the number of new cases of type 1 diabetes in children was unusually high in two of the hospitals in North West London compared to previous years,” said Logan.
“When we conducted a more in-depth investigation, some of these children had active coronavirus or had previously been exposed to the virus.”
Twenty-one of the youngsters – aged 23 months to 16 – were cleaned up for the coronavirus after developing a telltale fever or cough, two of whom came back positive.
Sixteen have been tested for antibodies to coronavirus – immune proteins that circulate in the bloodstream, suggesting an infection has already been fought off.
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Three of them were positive, implying that five of the children were infected with the coronavirus at the time or had already overcome it.
Scientists pointed out, however, that this may have been an underestimate.
“During the peak of the pandemic, widespread access to testing was not available, so we may have missed other cases of COVID-19 in those children who have newly-onset type 1 diabetes,” said said study author Rebecca Unsworth.
Be ‘aware of this potential connection’
Of the 30 patients, 70% arrived at the hospital with diabetic ketoacidosis (DKA), a serious complication that occurs if the body produces high levels of blood acids called ketones.
Type 1 diabetes occurs when cells that produce insulin, the hormone that lowers blood sugar, are mistakenly destroyed by a patient’s immune system.
If blood sugar is consistently high, it can lead to serious complications like heart attack, blindness or even limb amputations.
Although it may sound alarming, type 1 diabetes can be controlled with insulin injections or pumps.
ACD occurs when the body does not have enough insulin, which causes it to break down fat for fuel. The ketones then build up, which can be life threatening.
Among DKA patients, more than half (52%) were in serious condition – a much higher proportion than expected, scientists say.
Twelve of the children showed signs of clinical shock – a life-threatening condition that occurs when the body’s blood flow is restricted, while four had to be treated in intensive care.
Scientists believe their study is the first to show a potential link between the coronavirus and the emergence of type 1 diabetes in children, however, similar reports have emerged in China and Italy.
The coronavirus enters cells via the angiotensin converting enzyme receptor 2 (ACE2), which is “highly expressed” in the pancreas.
The study was conducted to “raise awareness of a possible link”, but “not definitive”, between the coronavirus and newly emerged type 1 diabetes.
“Our study was limited to a single region of the UK and more research is needed to establish whether there is a definitive link between the two, but in the meantime we hope clinicians will be aware of this potential link,” he said. Logan said.
Other experts agree that further studies are needed.
Professor Julian Hamilton-Shield of the University of Bristol called the research “interesting”, but added: “Any suggestion of an increase in the actual incidence should be treated with caution, as only certain contributing units have had more important presentations than expected in a very short period of time ”. .
Professor Paul Hunter of the University of East Anglia noted that the research “raises concern” with infections in general being known to trigger DKA in “susceptible individuals”.
“However, the epidemiological evidence presented in this article is weak and cannot be used as evidence of association,” he added.
“The main weakness of this article is the identification of an increase in only two of the five inpatient units.
“At any time in the UK, cases of new ketoacidosis will vary from year to year and it is often tempting but can be wrong to assume that any common infection in the community is the cause of an increase in diagnoses that could have happened. just by chance.
“Any association between diabetic ketoacidosis and COVID-19 may simply represent the association between ketoacidosis and any infection or may represent something specific to COVID-19.
“It is important that this observation be followed.”
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