{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:36:05Z","timestamp":1788388565704,"version":"build-2803163510"},"reference-count":50,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T00:00:00Z","timestamp":1690329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Diabetes mellitus (DM) represents a relevant risk factor regarding morbidity and mortality worldwide. However, only limited data exist regarding the impact of DM on the clinical outcome of patients with COVID-19 infection. Methods: All hospitalized patients with confirmed COVID-19-infection (ICD-code U07.1) during the year 2020 in Germany were included in the present study. Patients were stratified regarding the co-prevalence of DM (ICD-codes E10-E14), and the impact of DM on in-hospital case fatality and in-hospital adverse events was analyzed. Results: Overall, 176,137 hospitalizations with confirmed COVID-19 infection were documented; of these, 45,232 (25.7%) patients had an additional diagnosis of DM. Diabetic patients with COVID-19 were more often of male sex and 7 years older (median 76.0 (IQR: 66.0\u201383.0) vs. 69.0 (52.0\u201381.0) years, p &lt; 0.001). COVID-19 patients with DM demonstrated an aggravated comorbidity profile, as reflected by a higher Charlson comorbidity index (6.0 (IQR: 4.0\u20138.0) vs. 3.0 (1.0\u20135.0), p &lt; 0.001). Risk for pneumonia (OR 1.38 (95% CI: 1.35\u20131.41), p &lt; 0.001), acute respiratory distress syndrome (OR 1.53 (95% CI: 1.47\u20131.60), p &lt; 0.001), and need for intensive care (21.3% vs. 13.3%, p &lt; 0.001) were increased in DM patients. DM was an independent risk factor for acute kidney failure (OR 1.49 (95% CI: 1.44\u20131.53), p &lt; 0.001), dialysis (OR 1.56 (95% CI: 1.47\u20131.66), p &lt; 0.001), mechanical ventilation (OR: 1.49 (95% CI: 1.43\u20131.56), p &lt; 0.001), extracorporeal membrane oxygenation (OR 1.44 (95% CI: 1.27\u20131.62), p &lt; 0.001), major adverse cardiac and cerebrovascular events (OR: 1.24 (95% CI: 1.20\u20131.27), p &lt; 0.001), and in-hospital mortality (OR: 1.26 (95% CI: 1.22\u20131.30), p &lt; 0.001). Conclusions: In patients with COVID-19-infection, DM is a relevant risk factor for adverse events, including mortality. The vulnerable patient group of diabetics with COVID-19 requires intense medical care and monitoring during hospitalization.<\/jats:p>","DOI":"10.3390\/v15081627","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T01:50:37Z","timestamp":1690422637000},"page":"1627","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Diabetes Mellitus and Its Association with Adverse In-Hospital Outcomes in Patients with COVID-19\u2014A Nationwide Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5070-7280","authenticated-orcid":false,"given":"Volker H.","family":"Schmitt","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Hobohm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"},{"name":"Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9295-6223","authenticated-orcid":false,"given":"Ingo","family":"Sagoschen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Visvakanth","family":"Sivanathan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7823-7671","authenticated-orcid":false,"given":"Omar","family":"Hahad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Espinola-Klein","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"},{"name":"Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5503-4150","authenticated-orcid":false,"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0820-9584","authenticated-orcid":false,"given":"Karsten","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"},{"name":"Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"},{"name":"Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/S1473-3099(20)30314-5","article-title":"Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: A case series","volume":"20","author":"Buchholz","year":"2020","journal-title":"Lancet Infect. 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