Rompicherla, S, Noor, Edelen, R, Gallagher, M.P, Alonso, G.T, Daniels, M, Simmons, J, Ebekozien, O

Introduction: Children and adolescents with pre-existing type 1 diabetes (T1D) diagnosed with COVID-19 are at risk of adverse outcomes such as hospitalizations and diabetic ketoacidosis (DKA). There is limited data on the association between the presence of one or more comorbidities and the risk of adverse outcomes for patients with pre-existing T1D and COVID19.

Objectives: This study’s aim is to determine if pediatric and adolescent patients with T1D and other pre-existing comorbidities were more likely to experience adverse outcomes than T1D patients with COVID-19 who did not have any other comorbidities.

Methods: Data from 592 patients with previously established T1D aged <24 years with COVID-19 were analyzed from the T1Dx COVID-19 Surveillance Registry. Data were collected from 52 endocrinology clinics across the US using an online survey tool. Each clinic completed the survey using electronic medical record (EMR) data between April 2020 and May 2021. Descriptive statistics were used to describe the study population, and multivariate logistic regression models were used to analyze the relationship between age, insurance type, use of diabetes technology, presence of comorbidities, adverse outcomes, and hospitalization.

Results: The most frequent comorbidities were obesity (14%), asthma (11%), celiac disease (9%), and hypothyroidism (7%). T1D patients with at least one other comorbidity had a higher DKA presentation (16% vs 12%, p = 0.03) and a higher all-cause hospitalization rate (24% vs 15%, p = 0.02) compared to T1D patients without additional comorbidities. T1D Patients with comorbidities and COVID-19 were almost twice as likely to be hospitalized than those with no comorbidities (Odds Ratio 1.94, 95% CI: 1.23–3.03).The most frequent comorbidities were obesity (14%), asthma (11%), celiac disease (9%), and hypothyroidism (7%). T1D patients with at least one other comorbidity had a higher DKA presentation (16% vs 12%, p = 0.03) and a higher all-cause hospitalization rate (24% vs 15%, p = 0.02) compared to T1D patients without additional comorbidities. T1D Patients with comorbidities and COVID-19 were almost twice as likely to be hospitalized than those with no comorbidities (Odds Ratio 1.94, 95% CI: 1.23–3.03).

Conclusions: Our data reveal higher rates of hospitalizations and adverse outcomes among children and adolescents with T1D with at least one more comorbidities and COVID-19 in comparison with T1D patients without additional comorbidities.

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