Nov 10, 2021
2 minutes reading
disclosures: The authors report no relevant financial disclosures.
Adults with metabolic syndrome hospitalized for COVID-19 in a hospital in France are more likely to deteriorate and require more oxygen compared to patients without metabolic syndrome, study results show.
“About 80% of patients admitted to Avicenne Hospital in Bobigny, France for COVID-19 had metabolic syndrome,” Emmanuel Cosson, physician, doctorate, professor in the department of endocrinology, diabetology and nutrition at Avicenne Hospital, and colleagues wrote in a study published in Nutrition, metabolism and cardiovascular disease. “The patients with the metabolic syndrome may be at five times more risk of deterioration than patients without the metabolic syndrome. Identifying the metabolic syndrome at admission could improve the capacity of health care providers to predict the worsening of COVID-19.”
Researchers conducted a retrospective observational study of people admitted to Avicenne Hospital with COVID-19 from April 9 to May 29, 2020 and from February 1 to March 26, 2021. General data and medical history were extracted from medical records. COVID-19 worsening was the primary endpoint and was defined as needing a nasal oxygen flow of 6 liters or more per minute within 28 days of hospitalization. Non-invasive ventilation was analyzed as a secondary endpoint.
Metabolic syndrome was defined with three of the following five components: Android obesity with a waist circumference of 88 cm or more for women and 102 cm or more for men; an HbA1c of 5.7% or higher or a prescription for drug treatment or a diabetes diagnosis; history of hypertension or repeated measurements of high blood pressure; triglyceride content of 1.6 mmol/L or higher; and HDL cholesterol less than 1 mmol/L for men or 1.6 mmol/L for women.
Of the 155 patients included in the analysis, 36.1% experienced COVID-19 worsening, 16.1% required non-invasive ventilation, 14.1% were admitted to the ICU, and 5.8% died.
Of the study cohort, 81.3% had metabolic syndrome, 72.3% had android obesity, 89.4% had high HbA1c, 60% had high blood pressure, 43.7% had high triglyceride levels, and 85.9% had low HDL cholesterol.
The group with metabolic syndrome had a higher proportion of people with worsening COVID-19 compared to the group without metabolic syndrome (41.3% vs. 13.8%; p < .01). A higher proportion of people with the metabolic syndrome also received non-invasive ventilation compared to those without (19.1% vs. 3.1%; p = .05).
Those with metabolic syndrome had a significantly greater chance of worsening COVID-19 during hospitalization than those without metabolic syndrome (OR = 5.3; 95% CI, 1.3-20.2). Among the individual components of the metabolic syndrome, high HbA1c and high triglycerides were independently associated with worsening of COVID-19. The findings did not differ when fasting plasma glucose was used instead of HbA1c as a component of the metabolic syndrome.
In addition, researchers observed a link between the frequency of worsening of COVID-19 and how many components of the metabolic syndrome a person encountered.
“We found an association between a greater number of components of the metabolic syndrome and more frequent exacerbation of COVID-19,” the researchers wrote. “It would suggest that consideration should be given to the inter-association between all five components of the metabolic syndrome and their association with disease in order to identify patients most at risk for worsening COVID-19.”