Abstract: Coronavirus disease 19 (COVID19) is the trend of healthcare system since the last two years. The infection with COVID 19 in type 2 diabetes mellitus (T2DM) patients has been signified in severity of the disease symptoms. Cytokeratin 20 as well as Fe, Cu and Zn elements were investigated in T2DM with and without the incidence of COVID19. The study has included 84 subjects, from Al-Fallujah General Hospital; 28 patients were diagnosed with T2DM, 28 patients were diagnosed with T2DM and infected by the SARS-Cov-2, and 28 healthy people to control the study, then the serum of the fasting individuals were analyzed for glucose, cytokeratin 20, Fe, Cu, and Zn. The results have shown significant (P<0.05) elevated levels of glucose, cytokeratin 20, Cu, Fe, and Cu/Zn and Fe/Zn ratios in T2DM patients with and without COVID19, compared to control. The highest obtained significant values were in T2DM patients with COVID19. The level of Zn was reduced significantly (P<0.05) in T2DM patients with and without COVID19, with T2DM associated COVID19 have shown the lowest Zn levels. The receiver operating characteristic (ROC) curve has indicated that glucose, cytokeratin 20, and the ratio of Fe/Zn were excellent sensitive markers in the prognosis of T2DM associated COVID19. Furthermore, the ROC indicated that Zn and Cu/Zn ratio are good sensitive markers, while Fe and Cu were fair sensitive markers in the prognosis of T2DM associated COVID19. The results have shown important role of cytokeratin 20 in the pathophysiology of T2DM and COVID19 which may correlate with abdominal inflammation of COVID19 patients. Moreover, the significant alteration of Fe, Cu, and Zn may follow the oxidative imbalance of T2DM and COVID19 patients.