During the severe acute respiratory distress virus coronavirus type 2
(SARS-CoV-2) pandemic, many women were infected during their pregnancies. The
SARS-CoV-2-induced coronavirus disease 19 (COVID-19) has an impact on maternal
health and pregnancy outcomes; peripartum and perinatal morbidity and mortality
are increased. Pregnancy is considered a risk factor for severe COVID-19 course.
Additional risk factors during pregnancy are diabetes mellitus, gestational
diabetes mellitus (GDM), and obesity. Systemic inflammation can lead to severe
metabolic dysregulation with ketoacidosis. The endocrine pancreas is a target
organ for SARS-CoV-2 and the fetal risk depends on inflammation of the placenta.
Up to now there is no evidence that SARS-CoV-2 infection during pregnancy leads
to permanent diabetes in mothers or their offspring via triggering autoimmunity
or beta cell destruction. The frequently observed increased prevalence of GDM
compared to the years before the pandemic is most likely due to changed
lifestyle during lockdown. Furthermore, severe COVID-19 may be associated with
the development of GDM due to worsening of glucose tolerance. Vaccination with a
mRNA vaccine is safe and highly effective to prevent infection and to reduce
hospitalization. Registries support offering evidence-based recommendations on
vaccination for pregnant women. Even with the current omicron virus variant,
there are increased risks for symptomatic and unvaccinated pregnant women.