A large retrospective cohort study of over 600,000 pediatric patients found children diagnosed with COVID-19 had a relative risk of 1.58 for developing type 2 diabetes within 6 months, compared to those diagnosed with other respiratory infections.
The study, published in JAMA Network Open, analyzed electronic health records of 613,602 patients aged 10-19 years from 2020 to 2022. The research, led by Case Western Reserve University, excluded patients with pre-existing diabetes and used propensity score matching to compare 306,801 children diagnosed with COVID-19 to an equal number with other respiratory infections (ORIs).
Along with finding the elevated relative risk (RR) of 1.58 for for developing type 2 diabetes within 6 months, subgroup analysis showed even higher risks among children with overweight/obesity and those who were hospitalized for COVID-19. To reduce bias from early diagnoses, the study performed additional analyses excluding T2D diagnoses made within the first 1 to 3 months post-infection. The increased risk remained significant across all time intervals examined, including at 3-6 months with. a relative risk of 1.63.
The COVID-19 cohort included 52.8% female and 47.1% male patients, with a mean age of 14.9 years. The study used data from the TriNetX platform, which includes deidentified electronic health records from over 100 million patients across the U.S.
Though the absolute risk increase was a modest 4.8 per 10,000 in the general population, it represented a notable burden among children with overweight or obesity, with an excess risk of 17.0 per 10,000 in this subgroup.
The researchers noted some potential confounding factors, such as undocumented COVID-19 in the ORI group, could have underestimated the true impact of SARS-CoV-2. Additionally, socioeconomic status, BMI trajectory, and vaccination status were not consistently available in the deidentified dataset.
These findings align with prior research showing increased T2D risk in adults following COVID-19 and suggest a need for continued monitoring of pediatric diabetes outcomes as the pandemic evolves.
The authors declared having no competing interests.