Valid glucose measurements during follow up (median 6 month) was available for 61 out of 121 and 20 out of 55 patients with pre-existing diabetes or COVID-associated hyperglycaemia, respectively. comorbidities, increased levels of inflammatory markers, and indicators of multi-organ injury than those with pre-existing diabetes, while islet autoimmunity prevalence and anti-SARS-CoV-2 antibody responses were similar. COVID-associated hyperglycaemia was associated with a poorer clinical outcome and a longer viral clearance time compared to pre-existing diabetes. This strongly supports the need to screen all COVID-19 patients for hyperglycaemia at the time of admission despite a mute personal or family history of diabetes and to treat them in order to reach and maintain good glycemic control during hospitalization for COVID-19 pneumonia. Abstract Aim. The aim of the Rosavin current study was to compare clinical characteristics, laboratory findings, and major outcomes of patients hospitalized for COVID-19 pneumonia with COVID-associated hyperglycaemia or pre-existing diabetes. Methods. A cohort of 176 adult patients with a diagnosis of pre-existing diabetes (= 112) or COVID-associated hyperglycaemia (= 55) was studied. Results. Patients with COVID-associated hyperglycaemia had lower BMI, significantly less comorbidities, and higher levels of inflammatory markers and indicators of multi-organ injury than those with pre-existing diabetes. No differences between pre-existing diabetes and COVID-associated hyperglycaemia were evident for symptoms at admission, the humoral response against SARS-CoV-2, or autoantibodies to glutamic acid decarboxylase or interferon alpha-4. COVID-associated hyperglycaemia was independently associated with the risk of adverse clinical outcome, which was defined as ICU admission or death (HR 2.11, 95% CI 1.34C3.31; = 0.001), even after adjustment for age, sex, and other selected variables associated with COVID-19 severity. Furthermore, at the same time, we documented a negative association (HR 0.661, 95% CI 0.43C1.02; = 0.063) between COVID-associated hyperglycaemia to swab negativization. Conclusions. Recognizing hyperglycaemia as a specific clinical entity associated with COVID-19 pneumonia is relevant for early and appropriate patient management and close monitoring for the progression of disease severity. = 584) was previously analysed for their humoral response against SARS-Cov-2 (= 509), while the second cohort (= 169) Rosavin was studied for the development of thromboembolic complications. The study was approved by the local Institutional Review Board (Comitato EticoOspedale San Raffaele; protocol n 34/int/2020; “type”:”clinical-trial”,”attrs”:”text”:”NCT04318366″,”term_id”:”NCT04318366″NCT04318366), and all patients signed a written informed consent. A confirmed case was defined as the presence of symptoms and radiological findings suggestive of COVID-19 RAB11FIP3 pneumonia and/or a SARS-CoV-2-positive RT-PCR test from a nasal/throat (NT) swab. Demographic information, clinical features, and laboratory tests were obtained within 72 h of admission. Data were collected directly through patient interviews or medical chart reviews. Data regarding patient comorbidities were collected during hospitalization or after discharge from both structured baseline patient interviews and hospital paper Rosavin or electronic medical records. All disease diagnoses present at the date of infection were included as comorbidities. Data were verified by data managers and clinicians for accuracy and were crosschecked in blind. Data were recorded until hospital discharge or in-hospital death, whichever occurred 1st. We also recorded mortality and swab negativization beyond hospital discharge through our dedicated follow-up medical center: for individuals who did not attend the follow-up medical center, we Rosavin verified the individuals vital status with their either family members or their family physician. 2.2. Laboratory Variables Routine blood checks encompassed serum biochemistry (including renal and liver function, lactate dehydrogenase (LDH)), total blood count Rosavin with differential, markers of myocardial damage (troponin T and pro-brain natriuretic peptide (proBNP)), and swelling markers (C-reactive protein (CRP), ferritin, erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), procalcitonin). An extended coagulation profile was acquired, which included D-dimer, PT, PTT, fibrinogen, and antithrombin activity. Specific antibodies to different SARS-CoV-2 antigens, interferon alpha-4 and glutamic acid decarboxylase (GAD) were tested by a luciferase immunoprecipitation system (LIPS) assay, as previously described [31]. 2.3. Definition of Diabetes Study participants were defined as having (a) pre-existing diabetes if they had a recorded analysis of diabetes before hospital admission for COVID-19 pneumonia (fasting plasma glucose (FPG) 7.0 mmol/L or HbA1c 6.5% (48 mmol/mol), or if they were prescribed diabetes medications); or (b) COVID-associated hyperglycaemia if they experienced a mean fasting plasma glucose in the absence of infusions of dextrose 7.0 mmol/L during hospitalization for COVID-19 pneumonia in the presence of a negative history for diabetes and/or normal glycated haemoglobin level in the last 12 months and in the absence of prescribed diabetes medications. We computed mean fasting glucose and glucose variability (standard deviation) from all fasting laboratory glucose values measured during hospitalization. The analysis of pancreatogenic and steroid-induced diabetes was attributed to individuals whose diabetes was reasonably secondary to their exocrine pancreatic disease or steroid use. The analysis of type 1 diabetes was attributed to individuals whose diabetes was connected at onset with evidence of islet autoimmunity. The analysis of type 2 diabetes was attributed to all individuals who did not fulfil.