SARS-CoV-2 Infection Doubles T1D Risk in Children

TOPLINE:

In a large, population-based cohort, previously healthy children and adolescents who experienced acute SARS-CoV-2 infection had more than twice the risk of developing type 1 diabetes (T1D) within 6 months as those who were never infected.

METHODOLOGY:

• During the COVID-19 pandemic, the incidence of T1D among children and adolescents aged 0-17 years increased; however, the contribution of SARS-CoV-2 infection to this rise remains uncertain.
• Researchers in England conducted a population-based cohort study using linked databases and analysed 1,087,604 hospitalised children and young people (51.4% boys) who tested positive for SARS-CoV-2 to assess the association between the infection and new-onset T1D in the post-acute period.
• These participants were compared with children and young people who were not exposed to the SARS-CoV-2 infection and were hospitalised for trauma or elective procedures during the pandemic (May 2020 to August 2022) or in the 2 years prior to it.
• The primary outcome was new-onset T1D in the post-acute period (which is 6 months after 28 days from a positive test); associations were also examined according to the dominant SARS-CoV-2 variant at cohort entry.

TAKEAWAY:

• Among the participants who tested positive for SARS-CoV-2 infection, 475 developed T1D during the post-acute period, with an incidence rate of 90.5 (95% CI, 82.7-99.0) per 100,000 person-years compared with rates ranging from 22.4 to 37.7 per 100,000 person-years in the unexposed cohorts.
• Children and young people who were positive for SARS-CoV-2 were more than twice as likely to develop T1D in the post-acute period as the unexposed cohorts (hazard ratio, 2.4-4.2; P < .001 for all).
• The associations appeared strongest during the Delta variant period (May 18, 2021, to December 13, 2021), although analyses were limited by small numbers and wide CIs.

IN PRACTICE:

“Our results support growing evidence of an association between SARS-CoV-2 infection and new-onset type 1 diabetes,” the authors wrote.

SOURCE:

This study was led by Joseph L. Ward, King’s College London, London, England. It was published online on June 17, 2025, in Diabetic Medicine.

LIMITATIONS:

This study was limited by incomplete or inaccurate diagnostic coding. The study lacked information on prescription or autoantibody data to ascertain the type of diabetes; hence, some cases may have been misclassified. The inability to adjust for exposure to non-SARS-CoV-2 infections and changes in testing patterns during the pandemic may have affected the results.

DISCLOSURES:

This study was funded by the National Institute for Health and Care Research. One author reported being a consultant and speaker and receiving grants from various pharmaceutical companies and serving as a member of the UK Scientific Advisory Group for Emergencies. Another author disclosed holding the position of the National Clinical Director for Diabetes and Obesity at NHS England in the recent past.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.