Metabolic Syndrome Linked to Increased Risk of COVID-19 Mortality

Patients with a combination of high blood pressure, obesity, and diabetes who are hospitalized with coronavirus disease 2019 (COVID-19) may be more likely to die from the disease, according to a new study.¹

Results from the study, published in Diabetes Care, showed that metabolic syndrome was linked to worse outcomes from COVID-19. Individuals with metabolic syndrome were over 3 times more likely to die, according to the findings.

For the study, investigators followed outcomes for 287 patients hospitalized for COVID-19 at Tulane Medical Center and University Medical Center New Orleans from March 30 to April 5. Of these patients, approximately 85% identified as non-Hispanic Black, and the mean age was 61 years old. Almost 57% of patients were women.

The most common conditions were hypertension (80%), obesity (65%), diabetes (54%), and low high-density lipoprotein (HDL). The investigators compared 2 groups: patients who were diagnosed with metabolic syndrome and those without metabolic syndrome. Outcomes were measured based on if patients were admitted to an intensive care unit (ICU), placed on a ventilator, developed acute respiratory distress syndrome (ARDS), or died from the disease.

Analyses showed that hypertension, obesity, and diabetes individually did not show an association with mortality. However, the combination of the 3 conditions increased the odds of worsened COVID-19 outcomes. When comparing outcomes of patients with metabolic syndrome with those without, 56% versus 24% required ICU, 48% versus 18% required a ventilator, 37% versus 11% developed ARDS, and 26% versus 10% died, respectively.

Overall, after accounting for age, sex, race, hospital location, and other conditions, the patients with metabolic syndrome were 3.4 times more likely to die from COVID-19, according to the investigators. These patients were also approximately 5 times more likely to be admitted to the ICU, need a ventilator, or develop ARDS.

“Together, obesity, diabetes and pre-diabetes, high blood pressure, and abnormal cholesterol levels are all predictive of higher incidents of death in these patients,” lead author Joshua Denson, MD, MS, assistant professor of medicine and pulmonary and critical care medicine physician at Tulane University School of Medicine, said in a press release.² “The more of these diagnoses that you have, the worse the outcomes. The underlying inflammation that is seen with metabolic syndrome may be the driver that is leading to these more severe cases.”

References

1. Xie J, Zu Y, Alkhatib A, T. Pham T, et al. Metabolic syndrome and COVID-19 mortality among adult Black patients in New Orleans. Diabetes Care. 2020. https://doi.org/10.2337/dc20-1714

2. Metabolic syndrome linked to worse outcomes for COVID-19 patients. News Release. Tulane University; August 25, 2020. Accessed August 26, 2020. https://news.tulane.edu/pr/metabolic-syndrome-linked-worse-outcomes-covid-19-patients