Patients with metabolic syndrome had worse outcomes for COVID-19

Patients hospitalized with the novel coronavirus (COVID-19) who had a combination of high blood pressure, obesity, and diabetes were over three times more likely to die from the disease, according to a new study by researchers at Tulane University and published in the journal Diabetes Care.

For the study, researchers 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, which was at the peak of the pandemic in New Orleans. More than 85 percent of patients in the study identified as non-Hispanic Black. The mean age was 61 years old and almost 57 percent were women.

Metabolic syndrome is a cluster of at least three of five conditions, hypertension, high blood sugar, obesity, high triglycerides, and low high-density lipoprotein (HDL) cholesterol, that increases risk for cardiovascular disease. The most common conditions in the study were hypertension (80 percent), obesity (65 percent), diabetes (54 percent), and low HDL cholesterol (39 percent).

Researchers looked at two groups, those diagnosed with metabolic syndrome and those who weren't. They tracked outcomes including 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.

Almost 66 percent of the patients in the study had metabolic syndrome. When these cases were compared with patients without the condition, 56 percent versus 24 percent required the ICU, 48 percent versus 18 percent required a ventilator, 37 percent versus 11 percent developed ARDS, and 26 percent versus 10 percent died.

Importantly, 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 than those who didn't have the condition. These patients were also nearly five times more likely to be admitted to an ICU, need a ventilator, or develop ARDS.

The study didn't find an increase in mortality for patients when only one of the conditions clustered with metabolic syndrome were examined alone. However, being obese or having diabetes was associated with increased odds of ICU admission and being put on a ventilator, the researchers said.

The researchers said they would advise anyone who meets the criteria for metabolic syndrome to be vigilant in taking measures to reduce risk or exposure to COVID-19.

"Metabolic 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," said Joshua Denson, MD, MS, lead author of the study, assistant professor of medicine, and pulmonary and critical care medicine physician at Tulane University School of Medicine, in a statement. “I would say it should impact both preventing your exposures and, if you end up getting sick, you should probably see your doctor sooner."

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