The incidence of type 1 diabetes increased during the COVID-19 pandemic. Temporal relationships between COVID-19 infection and the incidence of type 1 diabetes as well as the development of islet autoimmunity are reported. It remains unknown whether COVID-19 infection accelerates disease progression in children with preexisting islet autoimmunity. The study examined whether there is an association between COVID-19 infection and progression to clinical diabetes in youth with presymptomatic type 1 diabetes.