1887
Volume 2026, Issue 1
  • EISSN: 2220-2749

Abstract

The relationship between clinical indicators and illness severity in hospitalized patients with both diabetes mellitus (DM) and COVID-19 remains incompletely understood, particularly with respect to endocrine markers.

This study aimed to identify clinical predictors of critical illness in hospitalized adults with DM and COVID-19 and to develop a predictive nomogram for individualized risk assessment.

This retrospective cross-sectional study enrolled 393 hospitalized patients with confirmed DM and COVID-19, who were categorized into non-critical ( = 309) and critical ( = 84) groups. We evaluated a comprehensive panel of candidate predictors, including demographic characteristics, vital signs, and laboratory markers such as C-reactive protein (CRP), fasting C-peptide (FCP), and free triiodothyronine (FT3). Multivariable logistic regression was used to develop the prediction model.

Multivariate logistic regression identified several independent predictors of critical illness. Elevated levels of blood urea nitrogen (BUN) (OR: 1.100, 95% CI: 1.026–1.183), serum creatinine (SCr) (OR: 1.027, 95% CI: 1.011–1.043), and CRP (OR: 1.011, 95% CI: 1.005–1.019), along with advanced age (OR: 1.073, 95% CI: 1.039–1.112), were significant risk factors. Conversely, lower levels of FCP (OR: 0.483, 95% CI: 0.305–0.737), FT3 (OR: 0.519, 95% CI: 0.313–0.835), and serum sodium (OR: 0.911, 95% CI: 0.860–0.962) were independent protective factors. The resulting nomogram showed excellent discrimination (C-index = 0.964).

A combination of clinical and laboratory parameters, including age, renal function, inflammatory markers, and endocrine indicators (FCP and FT3), can effectively predict COVID-19 severity in patients with DM. The developed nomogram provides a practical tool for early risk stratification in this high-risk population.

© 2025 The Author(s), licensee HBKU Press.
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2026-03-16
2026-03-17

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Clinical indicators for predicting illness severity in diabetic adults with COVID-19: A retrospective cross-sectional analysis
Avicenna 2026, 3 (2026); https://doi.org/10.5339/avi.2026.3
/content/journals/10.5339/avi.2026.3
/content/journals/10.5339/avi.2026.3
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  • Article Type: Research Article
Keyword(s): COVID-19, diabetes mellitus, nomograms, prognosis and risk factors

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