A new study has found that people with metabolic syndrome, which refers to a cluster of conditions that increase a person’s risk of cardiovascular issues, are more likely to have worse COVID-19 outcomes — including requiring ventilation and death.
The research, which appears in the journal Diabetes Care, provides further information on the underlying risk factors that affect the severity of COVID-19.
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As journals started publishing the results of observational studies drawing on data from the first wave of the pandemic, it became clear that some underlying medical conditions were associated with a greater chance of a person developing severe COVID-19.
According to the Centers for Disease Control and Prevention (CDC), some groups most at risk of severe disease include older adults and those with certain underlying medical conditions, such as cardiovascular diseases, obesity, and type 2 diabetes.
The new research highlights that obesity, hypertension, and diabetes, in particular, are more common in people who die from COVID-19 than heart or lung conditions.
According to the National Heart, Lung, and Blood Institute, metabolic syndrome is an umbrella term for several conditions that affect a person’s risk of heart conditions and other health problems.
To receive a diagnosis of metabolic syndrome, an individual needs to have three of five specific medical conditions.
According to the new research, these are:
- obesity
- diabetes or prediabetes
- hypertension
- hypertriglyceridemia
- low high-density lipoprotein (HDL) levels
If a person has metabolic syndrome, they are likely to have an ongoing low level of inflammation in their body.
The recent study explored the individual effects of obesity, hypertension, and diabetes on COVID-19 severity and compared them with their combined effect in metabolic syndrome.
To investigate, the researchers drew on data from 287 COVID-19 patients at two hospitals in New Orleans, LA, between March 30 and April 5, 2020. This was the initial local peak of the pandemic.
Over 85% of the people the researchers included in the study were non-Hispanic Black. The average age of the participants was 61, and almost 57% were women.
In total, 80% of the patients had hypertension, 65% had obesity, 54% had diabetes, and 39% had low HDL levels.
Overall, 66% of the people met the threshold for metabolic syndrome.
The researchers compared the patients with metabolic syndrome with those without, looking at the severity of COVID-19 as measured by admission to intensive care, ventilation, the development of acute respiratory distress syndrome (ARDS), or death.
Of the patients with metabolic syndrome:
- 56% required intensive care (vs. 24% of those without metabolic syndrome)
- 48% required ventilation (vs. 18% of those without metabolic syndrome)
- 37% developed ARDS (vs. 11% of those without metabolic syndrome)
- 26% died due to COVID-19 (vs. 10% without metabolic syndrome)
Even after accounting for a range of variables — including age, sex, race, and the location of the hospital — the researchers found that people with metabolic syndrome had a significantly higher chance of dying from COVID-19 (3.4 times as likely, overall) than people without metabolic syndrome.
People with metabolic syndrome were also almost five times as likely to be admitted to an intensive care unit, need ventilation, or develop ARDS.
Interestingly, the researchers found that there was no association between the individual conditions that collectively make up metabolic syndrome and death due to COVID-19.
However, obesity and diabetes were associated with a higher likelihood of needing admittance to intensive care and requiring ventilation.
According to lead study author Dr. Joshua Denson, an assistant professor of medicine at the Tulane University School of Medicine in New Orleans, LA: “Together, obesity, diabetes and prediabetes, high blood pressure, and abnormal cholesterol levels are all predictive of higher incidents of death in these patients. 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.”
This means that “[m]etabolic syndrome should be considered a composite predictor of COVID-19 lethal outcome, increasing the odds of mortality by the combined effects of its individual components.”
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