{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T15:21:16Z","timestamp":1793805676838,"version":"4.6.1"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2023,9,26]]},"abstract":"Importance<\/jats:title>The incidence of diabetes in childhood has increased during the COVID-19 pandemic. Elucidating whether SARS-CoV-2 infection is associated with islet autoimmunity, which precedes type 1 diabetes onset, is relevant to disease etiology and future childhood diabetes trends.<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine whether there is a temporal relationship between SARS-CoV-2 infection and the development of islet autoimmunity in early childhood.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Between February 2018 and March 2021, the Primary Oral Insulin Trial, a European multicenter study, enrolled 1050 infants (517 girls) aged 4 to 7 months with a more than 10% genetically defined risk of type 1 diabetes. Children were followed up through September 2022.<\/jats:p><\/jats:sec>Exposure<\/jats:title>SARS-CoV-2 infection identified by SARS-CoV-2 antibody development in follow-up visits conducted at 2- to 6-month intervals until age 2 years from April 2018 through June 2022.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The development of multiple (\u22652) islet autoantibodies in follow-up in consecutive samples or single islet antibodies and type 1 diabetes. Antibody incidence rates and risk of developing islet autoantibodies were analyzed.<\/jats:p><\/jats:sec>Results<\/jats:title>Consent was obtained for 885 (441 girls) children who were included in follow-up antibody measurements from age 6 months. SARS-CoV-2 antibodies developed in 170 children at a median age of 18 months (range, 6-25 months). Islet autoantibodies developed in 60 children. Six of these children tested positive for islet autoantibodies at the same time as they tested positive for SARS-CoV-2 antibodies and 6 at the visit after having tested positive for SARS-CoV-2 antibodies. The sex-, age-, and country-adjusted hazard ratio for developing islet autoantibodies when the children tested positive for SARS-CoV-2 antibodies was 3.5 (95% CI, 1.6-7.7; P<\/jats:italic>\u2009=\u2009.002). The incidence rate of islet autoantibodies was 3.5 (95% CI, 2.2-5.1) per 100 person-years in children without SARS-CoV-2 antibodies and 7.8 (95% CI, 5.3-19.0) per 100 person-years in children with SARS-CoV-2 antibodies (P<\/jats:italic>\u2009=\u2009.02). Islet autoantibody risk in children with SARS-CoV-2 antibodies was associated with younger age (&amp;lt;18 months) of SARS-CoV-2 antibody development (HR, 5.3; 95% CI, 1.5-18.3; P<\/jats:italic>\u2009=\u2009.009).<\/jats:p><\/jats:sec>Conclusion and relevance<\/jats:title>In young children with high genetic risk of type 1 diabetes, SARS-CoV-2 infection was temporally associated with the development of islet autoantibodies.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jama.2023.16348","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T11:30:45Z","timestamp":1694172645000},"page":"1151","source":"Crossref","is-referenced-by-count":38,"title":["SARS-CoV-2 Infection and Development of Islet Autoimmunity in Early Childhood"],"prefix":"10.1001","volume":"330","author":[{"given":"Marija","family":"Lugar","sequence":"first","affiliation":[{"name":"Technische Universit\u00e4t Dresden, Center for Regenerative Therapies Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Eugster","sequence":"additional","affiliation":[{"name":"Technische Universit\u00e4t Dresden, Center for Regenerative Therapies Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Achenbach","sequence":"additional","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany"},{"name":"Forschergruppe Diabetes, School of Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany"},{"name":"Forschergruppe Diabetes e.V. at Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thekla","family":"von dem Berge","sequence":"additional","affiliation":[{"name":"Kinder-und Jugendkrankenhaus AUF DER BULT, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Berner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel E. 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