Impact of SARS-CoV-2 Infection on Disease Trajectory in Youth with T1D: An EHR-Based Cohort Study from the RECOVER Program
Authors' conclusion
While a trend toward worse outcomes following COVID-19 in T1D patients was observed, these findings were not statistically significant. Continued clinical monitoring of youth with T1D following COVID-19 is warranted.
Study context
- Population
- Children <21 years with T1D and ≥1 HbA1c prior to cohort entry, March 01, 2020 to June 22, 2022Narrow Cohort 1,221
- Participants
- 2,404 children
- Exposure
- COVID-19 vs negative SARS-CoV-2 test
- Outcome
- T1D-related healthcare utilization (for diabetic ketoacidosis (DKA) or severe hypoglycemia)
- Follow-up
- ≥28 days after cohort entry
Methodological detailsEHR-based, RECOVER Program, propensity score-based matched cohort, weighted Cox regression, generalized estimating equation (GEE) models
- EHR-based
- RECOVER Program
- Propensity score-based matched cohort
- Weighted Cox regression
- GEE models
Main finding
As reported in the abstract
T1D-related healthcare utilization (DKA or severe hypoglycemia) ≥28 days after cohort entry
HR for utilization (COVID-19 vs negative not stated in sentence)
HR 1.45
95% CI 0.97, 2.16
Observational data: associations, not effects.
Further findings
HbA1c slope 91-180 days after cohort entry (Narrow Cohort)
- Rate of change of HbA1c increased for those with COVID-19 (0.138 vs. −0.002)
- P = 0.172
HbA1c change beyond 180 days (Narrow Cohort) · >180 days
- Greater declines in HbA1c in the positive cohort (−0.104 vs. 0.008 per month)
- P = 0.024
Original publication
Impact of SARS-CoV-2 Infection on Disease Trajectory in Youth with T1D: An EHR-Based Cohort Study from the RECOVER Program. Pediatr Diabetes. Published 9 August 2023. doi:10.
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