Table 2.
Studies included in the systematic review.
| Author, year | Country | Study design | Number of diabetic patients | Age | Gender (male) | DKA patients | DM type | New or pre-existing | HbA1C | Aim | Results | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pre | Post | Pre | Post | Pre | Post | Pre | Post | Pre | Post | |||||||
| Kamrath, 2021 | Germany | Multicenter cohort study | 3238 | 9.8 (6.0–12.9)a | 1799 (55.6%) | 1094 | Type 1 | New-onset | NR | Estimation of the relative risk of DKA in DM patients associated with COVID | In 1st half of the year, there is a significant association between the incidence of COVID and DKA with RR of 1.4 in every 50 COVID cases per week but in the 2nd half of the year, this association was insignificant. | |||||
| Ramgopal, 2021 | USA | Cross-sectional study | Emergency patient 27,874,730 (51,708 DKA) | Emergency patient 1,913,085 (5985 DKA) | 4.8 (1.6–10.7)a | 5.7 (1.8–12.2)a | 987,805 (51.6%) | 987,805 (51.6%) | 51,708 | 5985 | NR | NR | NR | Identification changes in the presentations of pediatric emergencies during COVID compared to the last 20 years | Emergency utilization was low after the pandemic in most diagnoses and increased in DKA rate | |
| Kucharska, 2020 | Poland | Cross-sectional study | 1961 | NR | Less than 18 years | 1054 boys (53.72%) | NR | 31.75% (622) | 36.67% | Type 1 | New-onset | 11.79 ± 2.63% | 13.41 ± 2.50% | Determination if COVID-19 lockdown affected the incidence rate of type 1 DM in the pediatric | Incidence rate of DM decreases in pandemic with worse conditions than in previous years | |
| Elbarbary, 2020 | Italy | Cross-sectional electronic survey | 86 DM patients | Under 18 years | 20 (23%) | 44 | 61 type 125 type 2 | Pre-existing | 7.6 (SD 1.6) | Determination of the management practice of HCP caring for pediatric patients with DM during COVID-19 | 15% reported a higher incidence of DKA. The majority of centers did not have DM COVID-19 positive, and from those who had, were just mild/moderate disease course | |||||
| Fisler, 2020 | USA | Retrospective cohort study | 5 DM | Under 21 years | 37 (48%) | 2 | NR | Pre-existing | NR | Determination factors associated with PICU admission in COVID-19 patients | DKA is one of the most indications of PICU admission | |||||
| Alonso, 2020 | USA | Survey |
266 61 hospitalized 205 non-hospitalized (44 DKA) |
Less than 19 years | 133 (50%) | 44 | Type 1 | Pre-existing | 11 in hospitalized; 8.2 in non-hospitalized | Description of the outcomes of COVID-19 in children and adolescents with type 1 diabetes and which factor increased the risk of disease | DKA was the most common adverse event for hospitalization and high HBA1c was significantly associated with hospitalization | |||||
| Sherif, 2021 | Egypt | Retrospective observational study | 36 patients | Mean and SD 8.4 ± 3.8 | 19 (52%) | 34 | Type 1 | 29 new; 7 pre-existing | 11.6 ± 2.2 | Determination of the characteristics of pediatric patients with type 1 DM during the pandemic and the prevalence of new-onset DM among patients with DKA | The pandemic increases the prevalence and severity of DKA in diabetic patients | |||||
aMedian and IQR.