Metabolic Syndrome and COVID-19 Mortality [COVID-19 and Physical Activity Series]

Metabolic Syndrome and COVID-19 Mortality Among Adult Black Patients in New Orleans by Dr. Xie and co-authors is a retrospective, observational study of hospitalized patients.  Data was collected between March 30 and April 5, 2020 at two tertiary, academic hospitals in New Orleans, an early epicenter with the highest death rate per capita in the U.S. (37.93 per 100,000 people) at that time.  Metabolic syndrome is a chronic low-grade inflammatory state and is diagnosed if three or more of the following five metabolic comorbidities exist: obesity, hypertension, prediabetes/diabetes, high triglycerides, and reduced HDL levels.  Dr. Xie and co-authors examined the association between obesity, hypertension and diabetes—individually and clustered as metabolic syndrome—and COVID-19 outcomes.  They found that metabolic syndrome was associated with 3.42 increased odds of hospital mortality (CI 1.52–7.69), 4.59 increased odds of intensive care unit requirement (CI 2.53–8.32), 4.71 increased odds of invasive mechanical ventilation (CI 2.50–8.87), and 4.70 increased odds of acute respiratory distress syndrome (CI 2.25–9.82) when compared with non-metabolic syndrome.  In contrast to comorbidities clustered as metabolic syndrome, in separate subgroup multivariable analyses, obesity, hypertension and diabetes individually showed no association with hospital mortality.  However, obesity was associated with increased odds of intensive care unit requirement (adjusted odds ratio [aOR] 2.18 [95% CI 1.25–3.81]), acute respiratory distress syndrome (aOR 2.44 [95% CI 1.28–4.65]), and invasive mechanical ventilation (aOR 2.36 [95% CI 1.33–4.21]).  Dr. Xie and co-authors concluded that patients with metabolic syndrome exhibited almost four times greater odds of fatal COVID-19 outcomes compared with those without metabolic syndrome.  These findings suggest that metabolic syndrome (obesity, hypertension, diabetes) is a composite predictor of COVID-19 lethal outcome, increasing the odds of mortality by the combined effects of its individual components. 

Xie, J., Zu, Y., Alkhatib, A., Pham, T. T., Gill, F., Jang, A., ... & Bojanowski, C. M. Metabolic Syndrome and COVID-19 Mortality Among Adult Black Patients in New Orleans. Diabetes care, dc201714.