P-503: Impact of the COVID-19 pandemic on the diagnosis and clinical presentation of type 1 diabetes mellitus in children referred to a tertiary public hospital in Rio de Janeiro
E Costa, A Costa, B Castro, L Tannus, N Campagnaro, P Collett-Solberg, R Berardo, I MadeiraAbstract
Introduction
Type 1 diabetes mellitus (T1DM) presents acutely and may lead to diabetic ketoacidosis (DKA). During the COVID-19 pandemic, diagnostic delays and increased DKA frequency were reported.
Objectives
To compare clinical and epidemiological characteristics of children referred to a tertiary public hospital in Rio de Janeiro for new onset TIDM before and during the COVID-19 pandemic.
Methods
Retrospective study of patients at the time of diagnosis of T1DM (2018–2021), divided into two groups: pre-pandemic (G1: 2018–2019) and pandemic (G2: 2020–2021). Variables included sex, age, DKA at diagnosis, duration of symptoms prior to diagnosis, and family history (FH). In G2, COVID-19-related data included symptoms and testing.
Results
A total of 49 children were included (G1 n=15; G2 n=34). No differences were observed between groups in: mean age at diagnosis (94.3±49.2 vs 89.0±56.4 months; p=0.3683); sex distribution [53% female (n=8), 47% male (n=7) vs 47% female (n=16), 53% male (n=18); p=0.9244]; frequency of family history of T1DM [26% (n=4) vs 28% (n=7); p=0.1145] and type 2 diabetes [50% (n=7) vs 50% (n=14); p=0.2551]; mean duration of symptoms prior to diagnosis (24.0±28.8 vs 31.1±45.5 days; p=0.9564); and frequency of DKA at diagnosis [60% (n=9) vs 70% (n=23); p=0.4485]. In G2, 23% (n=8) reported COVID-19 symptoms, 12% (n=4) had a positive test, and 26% (n=9) had household contact.
Conclusions
The time from symptom onset to diagnosis was prolonged regardless of the pandemic period, despite the expectation of longer delays and, consequently, a higher frequency of DKA diagnoses during the pandemic. This may reflect low clinical suspicion of T1DM in children, unchanged during the pandemic. Additionally, the number of COVID-19 cases was low and unlikely to have influenced the presentation of T1DM. These findings highlight the need for larger-scale studies to clarify the impact of the COVID-19 pandemic on the diagnosis and clinical presentation of T1DM.