People with metabolic syndrome hospitalized with COVID-19 more likely to require oxygen
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Adults with metabolic syndrome hospitalized for COVID-19 at a hospital in France are more likely to experience deterioration and require oxygen compared with patients without metabolic syndrome, according to study findings.
“Approximately 80% of patients admitted to Avicenne Hospital in Bobigny, France, for COVID-19 had metabolic syndrome,” Emmanuel Cosson, MD, PhD, professor in the department of endocrinology, diabetology and nutrition at Avicenne Hospital, and colleagues wrote in a study published in Nutrition, Metabolism and Cardiovascular Diseases. “The patients with metabolic syndrome might present with five times the risk of deterioration as compared to patients without metabolic syndrome. Identifying metabolic syndrome at admission could improve capacity of caregivers to predict COVID-19 deterioration.”
Researchers conducted a retrospective observational study of people admitted to Avicenne Hospital from April 9 to May 29, 2020, and from Feb. 1 to March 26, 2021, with COVID-19. General data and medical history were extracted from medical records. COVID-19 deterioration was the primary endpoint and defined as needing nasal oxygen flow at or above 6 L per minute within 28 days of hospitalization. Noninvasive ventilation was analyzed as a secondary endpoint.
Having three of the following five components were defined metabolic syndrome: 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 greater or a prescription for drug therapy or having a diabetes diagnosis; history of hypertension or repeated measurements of high blood pressure; triglyceride level of 1.6 mmol/L or higher; and HDL cholesterol of 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 deterioration, 16.1% needed noninvasive 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 a high HbA1c, 60% had high BP, 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 COVID-19 deterioration compared with the group without metabolic syndrome (41.3% vs. 13.8%; P < .01). A higher proportion of people with metabolic syndrome were also put on noninvasive ventilation compared with those without (19.1% vs. 3.1%; P = .05).
Those with metabolic syndrome had a significantly higher likelihood for COVID-19 deterioration during hospitalization than those without metabolic syndrome (OR = 5.3; 95% CI, 1.3-20.2). Of the individual metabolic syndrome components, high HbA1c and high triglycerides were independently associated with COVID-19 deterioration. The findings did not differ when fasting plasma glucose was used in place of HbA1c as a metabolic syndrome component.
Additionally, researchers observed a link between the frequency of COVID-19 deterioration and how many metabolic syndrome components a person met.
“We found an association between a higher number of metabolic syndrome components and more frequent COVID-19 deterioration,” the researchers wrote. “It would suggest that inter-association between all five metabolic syndrome components, and their association with the disease, should be taken into account in order to identify patients most at risk of COVID-19 deterioration.”
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