Metabolic Syndrome and clinical outcomes in patients infected with COVID-19: Does age, sex and race of the patient with Metabolic Syndrome matter?

BACKGROUND: Metabolic Syndrome (MetS) is highly prevalent worldwide and its individual components obesity, diabetes and hypertension have been identified as risk factors to develop severe COVID-19 illness, however data on MetS and clinical outcomes in COVID-19 is scarce. This study aims to determine association between MetS and severe disease outcomes, i.e. mortality, need for mechanical ventilation and ICU requirement among COVID-19 patients.

METHODS: A retrospective multi-hospital cohort study on 1871 patients with confirmed COVID-19 diagnosis. Patient data including demographics, comorbidities, BMI, smoking, laboratory data, and the clinical course of hospitalization was collected. Multivariable regression was performed adjusting for age, sex, race, insurance, smoking, and comorbidities.

RESULTS: A total of 1871 patients (median age 66 (IQR 54-75); 965 (51.6%) males; 1494 (80%) African Americans; median BMI 29.4 kg/m2 (IQR 25-35.8); 573 (30.6%) patients with MetS) were included. Patients with MetS had increased mortality (odds ratio (OR), 1.40; 95% CI, 1.11 - 1.75; p=0.004), higher ICU admission (OR, 1.68; 95% CI, 1.36 - 2.08; p<0.001) and increased need for mechanical ventilation (OR, 1.90; 95% CI, 1.52 - 2.37; p<0.001). Among individual comorbidities, diabetes had significant association with mortality (OR, 1.30; 95% CI, 1.05 - 1.63; p=0.02), ICU admission (OR, 1.56; 95% CI, 1.27 - 1.93; p<0.001) and need for mechanical ventilation (OR, 1.63; 95% CI, 1.30 - 2.03; p<0.001).

CONCLUSION: MetS is a better prognostic indicator for severe disease outcomes in COVID-19 patients than its individual components. Patients with MetS had significantly higher mortality, increased ICU admissions and need for mechanical ventilation. This article is protected by copyright. All rights reserved.