Newly-onset type 1 diabetes mellitus precipitated by COVID-19 in an 8-month-old infant

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Ashraf T Soliman
Mohamed Al-Amri
Khaled Alleethy
Nada Alaaraj
Noor Hamed
Vincenzo De Sanctis


Diabetic ketoacidosis, SARS-CoV-2, COVID-19, atypical symptoms, ACE 2


Summary. Type 1 diabetes mellitus (T1DM) is rare in infants and toddlers and is usually associated with a relatively high mortality when complicated with diabetic ketoacidosis (DKA). In infants, the classical symptoms of DKA are atypical and therefore many infants with DKA are mistreated for infections. We report a case of DKA precipitated by COVID-19 in an 8-month-old infant with newly diagnosed diabetes mellitus. This case is reported in view of its rarity and originality. The relation between T1DM and COVID19 infection is discussed.



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1. Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 Among Children in China. Pediatrics. 2020;145(6):e20200702. doi:10.1542/peds.2020-0702.
2. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20:689-696.
3. Qian G, Yang N, Ma AHY, et al. A COVID-19 Transmission within a family cluster by presymptomatic infectors in China [published online ahead of print, 2020 Mar 23]. Clin Infect Dis. 2020;ciaa316. doi:10.1093/cid/ciaa316.
4. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020;181:271-280.
5. Roca-Ho H, Riera M, Palau V, Pascual J, Soler MJ. Characterization of ACE and ACE2 Expression within Different Organs of the NOD Mouse. Int J Mol Sci. 2017;18(3):563. Published 2017 Mar 5. doi:10.3390/ijms18030563.
6. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2017;40(Suppl 1):S62-S69.
7. Barski L, Nevzorov R, Rabaev E, et al. Diabetic ketoacidosis: clinical characteristics, precipitating factors and outcomes of care. Isr Med Assoc J. 2012;14:299-303.
8. Jaeckel E, Manns M, Von Herrath M.Viruses and diabetes. Ann NY Acad Sci.2002; 958:7–25.
9. Roivainen M, Rasilainen S, Ylipaasto P, et al. Mechanisms of coxsackievirus-induced damage to human pancreatic betacells. J Clin Endocrinol Metab.2000; 85:432–440.
10. Ziegler CGK, Allon SJ, Nyquist SK, et al. SARS-CoV-2 Receptor ACE2 Is an Interferon-Stimulated Gene in Human Airway Epithelial Cells and Is Detected in Specific Cell Subsets across Tissues. Cell. 2020;181:1016-1035.
11. Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010;47:193-199.
12.Chee YJ, Ng SJH, Yeoh E. Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus. Diabetes Res Clin Pract. 2020;164:108166. doi:10.1016/j. diabres.2020. 108166.
13.Carlsson PO, Berne C, Jansson L. Angiotensin II and the endocrine pancreas: effects on islet blood flow and insulin secretion in rats. Diabetologia. 1998;41:127–133.
14. Guo J, Huang Z, Lin L, Lv J. Coronavirus disease 2019 (COVID-19) and cardiovascular disease: a viewpoint on the potential influence of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers on onset and severity of severe acute respiratory syndrome Coronavirus 2 infection. J Am Heart Assoc.2020;9(7):e016219. doi:10.1161/JAHA.120.016219.
15. Rubino F, Amiel SA, Zimmet P, et al. New-Onset Diabetes in Covid-19 [published online ahead of print, 2020 Jun 12]. N Engl J Med. 2020;NEJMc2018688. doi:10.1056/NEJMc2018688.

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