What are the predictors of new-onset diabetes in hospitalized COVID-19 patients?

In a recent study published in the International Journal of Environmental Research and Public Health, researchers evaluated the incidence and predictors of new-onset diabetes (NOD) in patients hospitalized with coronavirus disease 2019 (COVID-19).

Study: Predictors of New-Onset Diabetes in Hospitalized Patients with SARS-CoV-2 Infection. Image Credit: Minerva Studio/Shutterstock
Study: Predictors of New-Onset Diabetes in Hospitalized Patients with SARS-CoV-2 Infection. Image Credit: Minerva Studio/Shutterstock


Notwithstanding the measures introduced for prophylaxis and treatment of COVID-19, such as vaccines, antivirals, and monoclonal antibodies, the need for medical care and hospitalization remains high.

Numerous studies have reported that patients with severe COVID-19 have underlying comorbidities, such as cardiovascular disease, obesity, or hypertension. Reports suggest elevated morbidity and mortality rates in COVID-19 patients with type 2 diabetes mellitus (T2DM) than in those without T2DM, suggesting it may be an adverse prognostic factor.

About the study

The present study examined the incidence and predictors of NOD in COVID-19 patients. It was conducted on patients admitted to a Romanian hospital from November 10, 2020, to January 31, 2021. Patients aged 18 or above with any COVID-19 severity were included. Pregnant and diabetic individuals, patients hospitalized for less than two days, and those with missing biological specimens were excluded from the investigation.

NOD diagnosis during hospitalization was assessed using the criteria set by the American Diabetes Association. Mild disease was defined as having clinical symptoms without abnormal radiologic findings. Patients with pneumonia observed on a chest computed tomography (CT) scan were deemed as having a moderate disease.

Severe COVID-19 patients had respiratory distress, with a respiratory rate of ≥ 30/minute, peripheral oxygen saturation (SpO2) of ≤ 93%, and arterial oxygen partial pressure to fractional inspired oxygen (P/F) ratio ≤ 300 mmHg. Critical patients were those with respiratory failure, multi-system organ failure, sepsis, or those requiring mechanical ventilation/intensive care unit (ICU) care.

Laboratory investigations were routinely performed; these included a complete blood count, D-dimer, C-reactive protein (CRP), lactate dehydrogenase (LDH), alanine aminotransferase (ALAT), triglycerides, arterial blood gas (ABG), aspartate aminotransferase (ASAT), creatinine, procalcitonin, and interleukin (IL)-6. Samples were collected from the day of hospitalization until discharge.


Of the 514 screened patients, 219 were included in the analysis. NOD was diagnosed in 58 subjects (26.5%) during hospitalization. The median age of the patients was 69, and most were males. Loss of taste and dyspnea were frequent among those with NOD. Notably, subjects with NOD often developed severe COVID-19 and required ICU care, with a longer median length of hospital stay (12.5 days) than those without NOD (nine days).

There were no statistically significant differences in the time from symptom onset to hospitalization and the use of corticoid therapy between patients with and without NOD. The incidence of NOD was higher in those admitted to ICU (43.3%) than those who were not (23.8%). NOD incidence increased with disease severity – 3.3% in patients with mild disease and 33.8% in severe COVID-19 patients. 

At admission, ferritin, fasting plasma glucose (FPG), and LDH were significantly elevated among NOD patients. Although hypoxemia was pronounced among NOD patients, it did not reach statistical significance. The peak levels of biochemical investigations (FPG, LDH, CRP, ferritin, triglycerides) were significantly elevated in NOD patients.

Univariate logistic regression revealed a significant association between COVID-19 severity, admission levels of FPG and LDH, peak neutrophil and leucocyte levels, CRP, and ICU care with NOD during hospitalization.

A lower odds ratio (OR) was observed for admission P/F ratio and peak IL-6 levels. Multivariable regression analysis was performed with variables that were significant in univariate analysis.

Overall, the whole regression model significantly predicted NOD during hospitalization. Nonetheless, only one variable (LDH at admission) significantly contributed to the model. LDH levels of 657 units/liter at admission significantly predicted NOD during hospitalization with a sensitivity and specificity of 52.7% and 73.6%, respectively.


The study noted that one in four COVID-19 patients had NOD during hospitalization. NOD incidence increased with COVID-19 severity and was higher in those requiring ICU care. Univariate analysis showed that the NOD group had a 2.7-fold increased risk of severe COVID-19. Multivariable analysis found that only admission LDH levels significantly predicted NOD during hospitalization, concordant with findings from a meta-analysis that noted a correlation between diabetes and LDH levels in COVID-19 patients.

In summary, the researchers observed a high incidence of NOD among patients hospitalized with COVID-19, with LDH at admission being the significant predictor of NOD. The authors suggested interpreting the findings with caution as the persistence of NOD post-COVID-19 remains unknown. Given the study’s retrospective nature, some methodological disadvantages may have occurred. Therefore, prospective studies must examine NOD persistence and the relevance of tested biomarkers.

Journal reference:
Tarun Sai Lomte

Written by

Tarun Sai Lomte

Tarun is a writer based in Hyderabad, India. He has a Master’s degree in Biotechnology from the University of Hyderabad and is enthusiastic about scientific research. He enjoys reading research papers and literature reviews and is passionate about writing.


Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Sai Lomte, Tarun. (2022, October 18). What are the predictors of new-onset diabetes in hospitalized COVID-19 patients?. News-Medical. Retrieved on July 21, 2024 from https://www.news-medical.net/news/20221018/What-are-the-predictors-of-new-onset-diabetes-in-hospitalized-COVID-19-patients.aspx.

  • MLA

    Sai Lomte, Tarun. "What are the predictors of new-onset diabetes in hospitalized COVID-19 patients?". News-Medical. 21 July 2024. <https://www.news-medical.net/news/20221018/What-are-the-predictors-of-new-onset-diabetes-in-hospitalized-COVID-19-patients.aspx>.

  • Chicago

    Sai Lomte, Tarun. "What are the predictors of new-onset diabetes in hospitalized COVID-19 patients?". News-Medical. https://www.news-medical.net/news/20221018/What-are-the-predictors-of-new-onset-diabetes-in-hospitalized-COVID-19-patients.aspx. (accessed July 21, 2024).

  • Harvard

    Sai Lomte, Tarun. 2022. What are the predictors of new-onset diabetes in hospitalized COVID-19 patients?. News-Medical, viewed 21 July 2024, https://www.news-medical.net/news/20221018/What-are-the-predictors-of-new-onset-diabetes-in-hospitalized-COVID-19-patients.aspx.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.

You might also like...
New study highlights impact of sleep disturbances on COVID-19 and long COVID