Abstract

Objective: Studies using claims databases reported that SARS-CoV-2 infection >30 days earlier was associated with an increase in the incidence of type 1 diabetes. Using exact dates of diabetes diagnosis from the national register in Scotland linked to virology laboratory data, we sought to replicate this finding.

Research Design and Methods: A cohort of 1,849,411 individuals aged <35 years without diabetes, including all those in Scotland who subsequently tested positive for SARS-CoV-2, was followed from 1 March 2020 to 22 November 2021. Incident type 1 diabetes was ascertained from the national registry. Using Cox regression, we tested the association of time-updated infection with incident diabetes. Trends in incidence of type 1 diabetes in the population from 2015 through 2021 were also estimated in a generalized additive model.

Results: There were 365,080 individuals who had at least one detected SARS-CoV-2 infection during follow-up and 1074 who developed type 1 diabetes. The rate ratio for incident type 1 diabetes associated with first positive test for SARS-CoV-2 (reference category: no previous infection) was 0.86 (95% CI 0.62, 1.21) for infection >30 days earlier and 2.62 (95% CI 1.81, 3.78) for infection in the previous 30 days. However, negative and positive SARS-CoV-2 tests were more frequent in the days surrounding diabetes presentation. In those aged 0–14 years, incidence of type 1 diabetes during 2020–2021 was 20% higher than the 7-year average.

Conclusions: Type 1 diabetes incidence in children increased during the pandemic. However, the cohort analysis suggests that SARS-CoV-2 infection itself was not the cause of this increase.

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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at: https://www.diabetesjournals.org/journals/pages/license.

Cite as

McKeigue, P., McGurnaghan, S., Blackbourn, L., Bath, L., McAllister, D., Caparrotta, T., Wild, S., Wood, S., Stockton, D. & Colhoun, H. 2022, 'Relation of incident type 1 diabetes to recent COVID-19 infection: cohort study using e-health record linkage in Scotland', Diabetes Care, article no: dc220385. https://dx.doi.org/10.2337/dc22-0385

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Last updated: 29 October 2022
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