COVID-19 infection as a trigger for new-onset type 1 diabetes in a susceptible individual - or just coincidence?

Background: The cytotoxic effects of COVID-19 raise the question of a possible relation between COVID-19 infection and new-onset type 1 diabetes We report the case of an eight-year-old boy with new-onset type 1 diabetes and an asymptomatic COVID-19 infection Case presentation: The eight-year-old boy was hospitalized on December 18th, 2020 due to increased polyuria during the preceding 1 week Type 1 diabetes was diagnosed with autoantibodies against glutamic acid decarboxylase, tyrosine phosphatase and insulin The Hba1c value was 11 6% Upon admission, the PCR test for COVID-19 was positive, the duration of the infection was not clear due to the asymptomatic course, and antibodies were initially negative Significantly elevated antibodies against COVID-19 were detected 15 days later Conclusion: The laboratory findings led us to the hypothesis that the boy already had an increased risk of developing autoimmune diseases (HLA DR3-DQB1*02:01 and DR4-DQB1*03:02 positive) The Hba1c value allows speculation that the diabetes manifestation was already "on the way" and that a relatively recent COVID-19 infection could have accelerated the process The findings are in contrast to a recent report in which COVID-19 infection preceded the manifestation of an insulin-dependent diabetes mellitus by about 5-7 weeks Due to the paucity of reports, cases with a suspected connection between diabetes mellitus and COVID-19 infection should be entered into the CoviDiab registry (https://covidiab e-dendrite com)