CORONAVIRUS SARS-COV-2: Research in the DZD
Researchers around the world are working to learn more about the spread of the new coronavirus SARS-CoV-2 and the course of the disease Covid-19. In addition, they are searching for active substances to better treat the disease and stop the severe course of COVID-19. The German Center for Diabetes Research (DZD) is involved in various research initiatives and studies. DZD researchers are also investigating whether the coronavirus SARS-CoV-2 is particularly dangerous for people with diabetes and how the metabolic disease can be managed during the pandemic. Here is an overview, also of joint activities of the German Centres for Health Research (DZG).
Publications on Diabetes and COVID-19
Obesity, diabetes and high blood pressure increase COVID-19 mortality in young and middle-aged people
A recent study by the DZD shows that obesity, diabetes and high blood pressure in young and middle-aged people increase the risk of dying from COVID-19 to a level that is otherwise only observed in older people. It is therefore particularly important to intensify medical monitoring and therapy of younger COVID-19 patients - especially if either obesity, diabetes or elevated blood pressure are present. The study is based on data from the European Case Registry of Patients with SARS-CoV-2 Infection (LEOSS).
Stefan N, ... Birkenfeld AL. et al.: Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: the LEOSS Registry. Frontiers in Medicine (2022); DOI: doi.org/10.3389/fmed.2022.875430
COVID-19 infection increases type 2 diabetes risk
Diabetes not only increases the risk of becoming severely ill with COVID-19 or dying. People with SARS-CoV-2 infection may also be more likely to develop type 2 diabetes. This is suggested by a cohort study that included a representative panel of 1,171 physician practices across Germany (March 2020 to January 2021). During the study period, 35,865 people developed covid-19, and evaluations showed that patient:s with COVID-19 were more likely to develop type 2 diabetes compared with those with acute upper respiratory tract infections (AURI). The relative risk of developing T2D was 28% higher in the COVID group than in the AURI group.
Rathmann, W., Kuss, O. & Kostev, K.: Incidence of newly diagnosed diabetes after Covid-19. Diabetologia (2022). doi.org/10.1007/s00125-022-05670-0
Type 1 diabetes: more cases in children in Corona pandemic.
An analysis of data from the multicenter Diabetes Prospective Follow-up Registry (DPV*) showed that the incidence of type 1 diabetes (T1D) increased three months after a COVID 19 disease wave. Between January 2020 and June 2021, more children and adolescents in Germany developed new T1D than in comparable earlier periods. The cause of the increase is still unclear. The increased numbers may also have been an indirect consequence of the pandemic and not directly caused by COVID infection.
Kamrath, C. …. Holl, R. et al.: Incidence of Type 1 Diabetes in Children and Adolescents During the COVID-19 Pandemic in Germany: Results From the DPV Registry. Diabetes Care (2022) DOI: doi.org/10.2337/dc21-0969
More infections than reported: New study demonstrates importance of large-scale SARS-CoV-2 antibody screenings
A new study lead by DZD partner Helmholtz Zentrum München indicates a six-fold higher SARS-CoV-2 exposure rate among children in Bavaria, Germany, than reported cases. This highlights the value of population-based antibody screenings for pandemic monitoring. The study also describes a novel approach to measuring antibodies against SARS-CoV-2 with high accuracy.
The study results, together with an overview of the geographic distribution of antibody frequency, are available in a monthly updated online dashboard.
Hippich et al., 2020: Public health antibody screening indicates a six-fold higher SARS-CoV-2 exposure rate than reported cases in children. Med, DOI: 10.1016/j.medj.2020.10.003.
SARS-CoV-2 can damage pancreas
The coronavirus SARS-CoV-2 can also damage the pancreas and thus lead to type 1 diabetes. This is shown by the case of a young man (19 years old) who was examined by DZD researchers among others.
Hollstein, T. et al.: Autoantibody-negative Insulin-dependent Diabetes Mellitus after SARS-CoV-2 infection: a case report. Nat Metab (2020). DOI: 10.1038/s42255-020-00281-8
DZD researchers and a Germany-wide team investigated cases of ketoacidosis in young people with newly emerged diabetes during the first two months of the COVID 19 pandemic in Germany. The background to the study was the general decrease in the number of visits to doctors, which potentially led to delayed medical diagnoses. The number of dangerous metabolic disorders (ketoacidosis) also increased significantly during the corona crisis in children and adolescents.
Kamrath, C. et al. Ketoacidosis in Children and Adolescents With Newly Diagnosed Type 1 Diabetes During the COVID-19 Pandemic in Germany. JAMA 2020. doi:101001/JAMA.2020.13445
...but no significant increase in type 1 diabetes
DZD researchers also investigated the influence of the Corona lock down on new cases of type 1 diabetes in children and adolescents. This is because psychological stress is a risk factor for type 1 diabetes. The study showed that the lock down did not lead to a significant increase in the period from mid-March to mid-May 2020.
Tittel, S.R., Rosenbauer, J. et al., Did the COVID-19 lockdown affect the incidence of paediatric type 1 diabetes in Germany? Diabetes Care. doi.org/10.2337/dc20-1633
Relation between COVID-19 and obesity?
In a Nature Reviews Endocrinology "Comment", authors from the German Center for Diabetes Research (DZD), the Boston Children's Hospital and the Harvard T.H. Chan School of Public Health call for more research into the links between obesity, disproportionate fat distribution and impaired metabolic health and the severity of COVID-19.
Stefan N, Birkenfeld AL, Schulze MB, Ludwig DS. Obesity and impaired metabolic health in patients with COVID-19. Nat Rev Endocrinol. 2020, doi.org/10.1038/s41574-020-0364-6
Diabetes management during the pandemic
An international panel of experts in the field of diabetes and endocrinology - including researchers from the German Center for Diabetes Research (DZD) - have developed practical recommendations for managing diabetes during the pandemic and published them in 'Lancet Diabetes Endocrinology' (Personal View).
Bornstein et al: Practical recommendations for the management of diabetes in patients with COVID-19. Lancet Diabetes Endocrinol. 2020 Apr 23. pii: S2213-8587(20)30152-2. DOI: 10.1016/S2213-8587(20)30152-2.
LEOSS: Case Registry with Clinical Data on Patients with SARS-COV-2 Infection
When do patients become seriously ill after infection with the novel coronavirus SARS-CoV-2? What is the best way to treat them? Which measures have been successful so far? In order to answer these and many other questions about Covid-19, doctors and researchers need reliable clinical data. The Lean European Open Survey on SARS-CoV-2 Infected Patients (LEOSS) collects clinical data on patients with SARS-CoV-2 infection. To this end, all German Centres for Health Research are working together on the project initiated by the German Society of Infectious Diseases (DGI) together with the German Center for Infection Research (DZIF). For example, it is also possible to investigate whether and how preexisting illnesses influence the course of the disease. For this purpose, the DZD has compiled important diabetes values that are recorded in LEOSS and is involved in the recruitment of patients at the partner sites. The aim is to find out what influence obesity and diabetes have on the course of the disease.
WHO Solidarity Trial
Researchers around the world are working as quickly as possible to find active substances that can halt the severe course of COVID-19. It is hoped that drugs that have already been approved for other diseases such as HIV or malaria and have been shown to be effective against the novel coronavirus in the laboratory and in individual treatment trials may prove beneficial. The World Health Organization (WHO) has selected four particularly promising active substances or combinations of active substances (remdesivir, chloroquine or hydroxychloroquine, lopinavir and ritonavir) to be tested in a clinical trial program in several countries. In Germany, the DZIF, together with the German Centre for Health Research, is responsible for coordinating this solidarity trial. It is supported by all German Centres for Health Research (DZG)
Covid-19- Knowledge Graph: Making Knowledge Visible
In the COVID*Graph project, publicly available literature sources, patent specifications for COVID-19 and data sets from genome and molecular biology databases are linked and graphically presented in a knowledge graph. The aim is to help researchers find their way quickly and efficiently through the diverse data on COVID-19. The DZD data and knowledge management team plays a leading role in the project. Since people with diabetes have a higher incidence of severe complications in the case of a SARS-CoV-2 infection, DZD researchers are extending data integration technology to include diabetes-related data.
Quelle: Screenshot covidgraph.org
Tests for Antibodies in Existing Studies
Area-wide antibody tests against the novel coronavirus SARS-CoV-2 can help to obtain realistic values for the prevalence of infection with the pathogen. Researchers of the established screening study "Fr1da plus", which test children in Bavaria for early stages of type 1 diabetes, are now incorporating these tests directly into their investigations. Together with an existing network of about 600 pediatric and adolescent practitioners and under the direction of the DZD partner Helmholtz Zentrum München, they could now also be able to test up to 65,000 blood samples from the Fr1da-plus study for the presence of antibodies against SARS-CoV-2.
In addition, partner sites of the DZD are involved in research projects to better determine the prevalence of infection with the pathogen and to improve the diagnosis of COVID-19 by using cohorts, e.g. KORA (Cooperative Health Research in the Augsburg Region) and the German National Cohort (GNC) for epidemiological questions, starting the Prospective COVID-19 Cohort Munich and developing assays for the detection of antibodies against COVID-19. The Diabetes Patient History Documentation (DPV) will also record whether people with diabetes are affected by COVID-19.
LIFE & COVID Online Study
A new study on lifestyle and COVID-19 has been launched by the Diabetes Study Center of the Ludwig-Maximilians-University of Munich under PD Dr. Andreas Lechner. The extent to which lifestyle factors, such as diet and exercise, influence the severity of the disease course will be determined over a period of 12 months using a maximum of four online surveys. The recruitment of participants was completed in July 2020.
The team around Dr. Lechner is a Clinical Cooperation Group of the DZD partner Helmholtz Zentrum München.
Information About Corona and Diabetes at diabinfo.de
Especially in these times it is important that people with diabetes receive reliable and scientifically proven information. For this purpose, the national diabetes information portal www.diabinfo.de has set up the Diabetes and Coronavirus section with current information and answers to frequently asked questions about diabetes and corona. (In German)
Information by RKI
The Robert Koch Institute (RKI) also provides information on diabetes und COVID-19 on the Diabetes-Surveillance website.