COVID-19 fatality prediction in people with diabetes and prediabetes using a simple score upon hospital admission

Diabetes Obes Metab. 2021 Feb;23(2):589-598. doi: 10.1111/dom.14256. Epub 2020 Dec 4.


Aim: To assess predictors of in-hospital mortality in people with prediabetes and diabetes hospitalized for COVID-19 infection and to develop a risk score for identifying those at the greatest risk of a fatal outcome.

Materials and methods: A combined prospective and retrospective, multicentre, cohort study was conducted at 10 sites in Austria in 247 people with diabetes or newly diagnosed prediabetes who were hospitalized with COVID-19. The primary outcome was in-hospital mortality and the predictor variables upon admission included clinical data, co-morbidities of diabetes or laboratory data. Logistic regression analyses were performed to identify significant predictors and to develop a risk score for in-hospital mortality.

Results: The mean age of people hospitalized (n = 238) for COVID-19 was 71.1 ± 12.9 years, 63.6% were males, 75.6% had type 2 diabetes, 4.6% had type 1 diabetes and 19.8% had prediabetes. The mean duration of hospital stay was 18 ± 16 days, 23.9% required ventilation therapy and 24.4% died in the hospital. The mortality rate in people with diabetes was numerically higher (26.7%) compared with those with prediabetes (14.9%) but without statistical significance (P = .128). A score including age, arterial occlusive disease, C-reactive protein, estimated glomerular filtration rate and aspartate aminotransferase levels at admission predicted in-hospital mortality with a C-statistic of 0.889 (95% CI: 0.837-0.941) and calibration of 1.000 (P = .909).

Conclusions: The in-hospital mortality for COVID-19 was high in people with diabetes but not significantly different to the risk in people with prediabetes. A risk score using five routinely available patient variables showed excellent predictive performance for assessing in-hospital mortality.

Keywords: coronavirus infection, diabetes, prediabetic state.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Austria
  • COVID-19 / mortality*
  • COVID-19 / virology
  • Diabetes Mellitus, Type 2 / mortality*
  • Diabetes Mellitus, Type 2 / virology
  • Female
  • Health Status Indicators*
  • Hospital Mortality
  • Hospitals
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data*
  • Prediabetic State / mortality*
  • Prediabetic State / virology
  • Prospective Studies
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2