Increasing incidence and severity of childhood-onset type 1 diabetes in Latvia during the COVID-19 pandemic

Background During the COVID-19 pandemic in Latvia, there was a significant increase in new-onset childhood type 1 diabetes (T1D). The aim of this study is to analyze the influence of SARS-CoV-2 virus on initial manifestation of T1D and patterns of risk factors for disease development in children. Materials and methods In the cross-sectional part of the study, 277 patients aged 1–17 years with new-onset T1D hospitalized in Children’s Clinical University Hospital between 2017 and 2024 were selected and divided into two groups depending on COVID-19 history prior to T1D onset: (1) research group (past, laboratory-proven infection or positive SARS-CoV-2 antibodies at the time of hospitalization); (2) control group (negative COVID-19 history and prepandemic patients). Initial manifestation was evaluated by analyzing clinical presentation and blood gas tests. Among the risk factors, prenatal, dietary, and hereditary factors and infections were analyzed. Results The rate of incidence of T1D increased by 37.6% during the COVID-19 pandemic in Latvia ( p < 0.001). Children from the research group had a significantly more severe initial manifestation with lower pH levels at the time of admission ( p = 0.04). No association between more severe clinical presentation and delayed arrival at the hospital for any reason was found. There was a significantly lower prevalence of T1D in the family members of those patients exposed to SARS-CoV-2. Conclusion After exposure to SARS-CoV-2, patients in the cohort group had a more severe initial manifestation of T1D than patients without a history of COVID-19, which could not be attributed to the restrictions imposed by the pandemic or to other changes resulting from patient or primary care decisions.