{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:30:02Z","timestamp":1792621802068,"version":"4.5.0"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy, Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Diabetes mellitus (DM) has been consistently linked to severe coronavirus disease 2019 (COVID-19) and adverse outcomes; however, the extent to which DM independently predicts mortality and cardiovascular complications in real-world hospitalized cohorts remains debated, particularly in Eastern Europe. This study aimed to evaluate the impact of DM on cardiovascular complications and in-hospital outcomes among adults hospitalized with SARS-CoV-2 infection. Materials and Methods: We conducted a single-center retrospective observational cohort study including consecutive adult patients hospitalized with laboratory-confirmed SARS-CoV-2 infection between March 2020 and December 2024 at the \u201cVictor Babe\u0219\u201d Clinical Hospital of Infectious Diseases and Pneumophthisiology, Timi\u0219oara, Romania. DM status (type 1, type 2, or newly diagnosed diabetes) was defined using structured dataset fields. The primary outcome was in-hospital all-cause mortality. Secondary outcomes included ICU admission, length of stay, pulmonary embolism (PE) on CT pulmonary angiography (CTPA), and a composite of in-hospital cardiovascular\/thromboembolic complications. Multivariable logistic regression models adjusted for clinically relevant covariates (age, sex, BMI, vaccination status, hypertension, ischemic heart disease, atrial fibrillation, prior ischemic stroke, and admission creatinine). Results: A total of 395 patients were included; 98 (24.8%) had DM. Diabetic patients exhibited a high cardiometabolic burden (arterial hypertension: 83.7% vs. 77.4%, p = 0.242) and higher admission renal markers (urea: 55.6 [41.0\u201379.1] vs. 48.6 [39.2\u201368.0] mg\/dL, p = 0.047; creatinine: 1.04 [0.76\u20131.52] vs. 0.88 [0.59\u20131.33] mg\/dL, p = 0.008). In-hospital mortality was numerically higher in DM (9.2% vs. 6.7%, p = 0.560), as was ICU admission (7.1% vs. 4.7%, p = 0.503), without statistical significance. PE on CTPA occurred in 13.3% of DM vs. 11.4% of non-DM patients (p = 0.763). In univariable analysis, DM was not significantly associated with mortality (OR 1.40, 95% CI 0.62\u20133.19; p = 0.422) or ICU admission (OR 1.55, 95% CI 0.61\u20133.97; p = 0.356). After multivariable adjustment, DM remained not independently associated with mortality (adjusted OR 1.09, 95% CI 0.42\u20132.83; p = 0.854) or ICU admission (adjusted OR 1.19, 95% CI 0.42\u20133.36; p = 0.747). Conclusions: In this real-world Eastern European cohort of hospitalized adults with SARS-CoV-2 infection, diabetes mellitus was common and associated with significantly worse renal function at admission, but it was not statistically associated with in-hospital mortality or ICU admission after multivariable adjustment; however, the limited number of events and low events-per-variable raise concerns about model stability and potential false-negative findings. These findings support a risk-marker model in which adverse COVID-19 outcomes in diabetic patients are driven primarily by clustered vulnerability and organ dysfunction rather than diabetes status alone.<\/jats:p>","DOI":"10.3390\/medicina62020410","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:39:10Z","timestamp":1771846750000},"page":"410","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diabetes Mellitus and In-Hospital Outcomes in Hospitalized COVID-19 Patients: A Single-Center Eastern European Cohort Study (2020\u20132024)"],"prefix":"10.3390","volume":"62","author":[{"given":"Ioana-Georgiana","family":"Cotet","sequence":"first","affiliation":[{"name":"Doctoral School, Department of General Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Centre of Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Olivia","family":"Toma","sequence":"additional","affiliation":[{"name":"Discipline of Dermatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Center for the Morphologic Study of the Skin (MORPHODERM), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4951-1702","authenticated-orcid":false,"given":"Diana-Maria","family":"Mateescu","sequence":"additional","affiliation":[{"name":"Doctoral School, Department of General Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian-Cosmin","family":"Ilie","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sanitary Management, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Centre for Translational Research and Systems Medicine, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9215-5154","authenticated-orcid":false,"given":"Sorin","family":"Ursoniu","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sanitary Management, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Centre for Translational Research and Systems Medicine, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Alexandru","family":"Surducan","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sanitary Management, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Centre for Translational Research and Systems Medicine, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmin","family":"Gridan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Railway Clinical Hospital (CFR), Tudor Vladimirescu Street 13-15, 300173 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stela","family":"Iurciuc","sequence":"additional","affiliation":[{"name":"Cardiology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragos-Mihai","family":"Gavrilescu","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Dental District, Strada Z\u0103gazului Nr. 3, ONE Floreasca Vista, Sector 1, 014261 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-741X","authenticated-orcid":false,"given":"Cristina","family":"Tudoran","sequence":"additional","affiliation":[{"name":"Centre of Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Department VII, Internal Medicine II, Discipline of Cardiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"County Emergency Hospital \u201cPius Brinzeu\u201d, L. Rebreanu, Nr. 156, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e001858","DOI":"10.1136\/bmjdrc-2020-001858","article-title":"Adverse outcomes in COVID-19 and diabetes: A retrospective cohort study from three London teaching hospitals","volume":"9","author":"Distaso","year":"2021","journal-title":"BMJ Open Diabetes Res. 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