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. 2020 Nov-Dec;14(6):1979-1986.
doi: 10.1016/j.dsx.2020.10.012. Epub 2020 Oct 13.

The impact of metabolic syndrome on morbidity and mortality among intensive care unit admitted COVID-19 patients

Nasser Malekpour Alamdari  1 , Fateme Sadat Rahimi  2 , Siamak Afaghi  3 , Afshin Zarghi  4 , Shohra Qaderi  5 , Farzad Esmaeili Tarki  6 , Seyed Reshad Ghafouri  7 , Sara Besharat  8
Affiliations

The impact of metabolic syndrome on morbidity and mortality among intensive care unit admitted COVID-19 patients

Nasser Malekpour Alamdari et al. Diabetes Metab Syndr. 2020 Nov-Dec.

Abstract

Background and aims: Given the limited information describing the connection between metabolic syndrome (MetS) and Coronavirus Disease 2019 (COVID-19), we aimed to assess the impact of MetS on morbidity and mortality among COVID-19 patients.

Methods: This retrospective cohort study was performed from 1st April to May 3, 2020 on 157 ICU-admitted COVID-19 patients in Shahid Modarres Hospital in Tehran, Iran. Patients' clinical, laboratory and radiological findings, and subsequent complications, were collected and compared between MetS and non-MetS groups.

Results: 74 of all cases had MetS. Among the MetS components, waist circumference (p-value = 0.006 for men; p-value<0.0001 for women), Triglycerides (p-value = 0.002), and Fasting Blood Sugar (p-value = 0.007) were significantly higher in MetS group; with no statistical difference found in HDL levels (p-value = 0.21 for men; p-value = 0.13 for women), systolic blood pressure(p-value = 0.07), and diastolic blood pressure (p-value = 0.18) between two groups. Length of ICU admission (p-value = 0.009), the need for invasive mechanical ventilation (p-value = 0.0001), respiratory failure (p-value = 0.0008), and pressure ulcers (p-value = 0.02) were observed significantly more in MetS group. The Odds Ratio (OR) of mortality with 0(OR = 0.3660), 1(OR = 0.5155), 2(OR = 0.5397), 3(OR = 1.9511), 4(OR = 5.7018), and 5(OR = 8.3740) MetS components showed an increased mortality risk as the components' count increased. The patient with BMI>40 (OR = 6.9368) had more odds of fatality comparing to those with BMI>35 (OR = 4.0690) and BMI>30 (OR = 2.5287). Furthermore, the waist circumference (OR = 8.31; p-value<0.0001) and fasting blood sugar (OR = 2.4588; p-value = 0.0245) were obtained by multivariate logistic regression as independent prognostic factors for mortality.

Conclusion: The findings suggest a strong relationship between having MetS and increased risk of severe complications and mortality among COVID-19 ICU-admitted patients.

Keywords: COVID-19; Diabetes; Metabolic syndrome.

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Conflict of interest statement

Declaration of competing interest Authors declare no conflict of interests.

Figures

Fig. 1
Fig. 1
The comparison of median range of major symptoms, along with clinical course and complications’ occurrences between A: ICU-Admitted Patients with MetS, & B: ICU-Admitted Patients without MetS.
Fig. 2
Fig. 2
Relation of having MetS, not having MetS, the existence of 0–5 components of MetS, and different BMI categories, to mortality.
See this image and copyright information in PMC

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