Medical Journal of the Islamic Republic Of Iran

en Systemic Immune-Inflammation Index and Risk of Diabetes and Prediabetes Two Years Post-COVID-19: A Retrospective Cohort Study Internal Medicine Internal Medicine Original Research: Clinical Science Original Research: Clinical Science     Background: Post-COVID-19 metabolic complications, such as diabetes, are linked to systemic inflammation. The Systemic Immune-Inflammation Index (SII) may help predict these outcomes; however, evidence from non-Western populations remains limited.    Methods: In this retrospective cohort study, 2,060 COVID-19 patients hospitalized in 2020 in Iran were followed for two years. SII was calculated and categorized as normal or elevated. The incidence of diabetes and prediabetes was assessed using fasting blood sugar (FBS) and HbA1c levels. Linear regression analyses were conducted to examine associations between SII and metabolic outcomes, adjusting for potential confounders.    Results: Among participants, 73.4% remained normoglycemic, 7.5% developed prediabetes, and 19.1% developed diabetes. Linear regression analysis demonstrated a statistically significant but modest positive association between SII and FBS levels (β = 0.018; 95% CI: 0.004–0.032; P = 0.011). Other inflammatory markers showed no significant associations.    Conclusion: Elevated SII was modestly associated with higher fasting blood sugar levels two years after COVID-19 infection. Although the effect size was small, these findings suggest that systemic inflammation may play a role in long-term glycemic dysregulation, underscoring the importance of metabolic follow-up in individuals with heightened post-COVID inflammatory profiles.   Systemic Immune-Inflammatory, Diabetes, Prediabetes, Cohort 205 212 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-9588-1&slc_lang=en&sid=1 Ezatollah Rahimi ezatrahimi258@gmail.com 200319475328460097004 200319475328460097004 No Department of Internal Medicine, School of Medicine, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran Lotfollah Saed lotfollahsaed@yahoo.com 200319475328460097005 200319475328460097005 No Department of Internal Medicine, School of Medicine, Tohid Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran Nasrin Moghimi Nasrin_43ir@yahoo.com 200319475328460097006 200319475328460097006 No Cancer & Immunology Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Solmaz Derakhshan Baghi dr.solmaz.derakhshan@gmail.com 200319475328460097007 200319475328460097007 No Department of Internal Medicine, School of Medicine, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran Parisa Modaresi Dr.parisapatho@gmail.com 200319475328460097008 200319475328460097008 No Department of Pathology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran Narmin Baghi narminbaghi69@gmail.com 200319475328460097009 200319475328460097009 Yes Department of Internal Medicine, School of Medicine, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran