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. 2021 Aug 26;31(9):2596-2604.
doi: 10.1016/j.numecd.2021.05.016. Epub 2021 May 27.

Metabolic syndrome and the risk of COVID-19 infection: A nationwide population-based case-control study

Dong-Hyuk Cho  1 , Jimi Choi  2 , Jun Gyo Gwon  3
Affiliations

Metabolic syndrome and the risk of COVID-19 infection: A nationwide population-based case-control study

Dong-Hyuk Cho et al. Nutr Metab Cardiovasc Dis. .

Abstract

Background and aims: Metabolic syndrome (MetS) is a chronic, low-grade inflammatory disease. This study aimed to investigate the impact of MetS on the risk and severity of COVID-19.

Methods and results: We investigated a nationwide cohort with COVID-19 including all patients who underwent the test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Korea. The COVID-19 group included 4070 patients with positive SARS-CoV-2 test results, and the age- and sex-matched control group included 27,618 subjects with negative SARS-CoV-2 test results. The endpoints were SARS-CoV-2 positivity and the severity of COVID-19. The prevalence of MetS was 24.7% and 24.5% in the COVID-19 and control groups, respectively. The presence of MetS was not associated with the risk of developing COVID-19. Among the components of MetS, central obesity was associated with a higher risk of COVID-19 infection (adjusted odds ratio [aOR], 1.17; 95% confidence interval [CI], 1.06-1.28, P = 0.001). The presence of MetS was significantly associated with severe COVID-19 (aOR, 1.25; 95% CI, 0.78-2.00, P = 0.352). Among the individual components of MetS, prediabetes/diabetes mellitus was associated with a higher risk of severe COVID-19 (aOR, 1.61; 95% CI, 1.21-2.13, P = 0.001). The risk of severe COVID-19 linearly increased according to the number of metabolic components (P for trend = 0.005).

Conclusion: In this nationwide cohort study, the individuals with MetS had a significant increase in the risk of severe COVID-19 infection. These patients, particularly those with central obesity and insulin resistance, deserve special attention amid the COVID-19 pandemic.

Keywords: COVID-19; Metabolic syndrome; Nationwide cohort study; SARS-CoV-2.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Disposition of the patients with coronavirus disease and matched controls. The figure demonstrates the flowchart of the study population.
Figure 2
Figure 2
Continuous association between the metabolic profile and COVID-19. The adjusted odds ratio with 95% confidence interval was demonstrated. The WC and FBG levels were associated with a higher risk of COVID-19 infection. COVID-19, coronavirus disease; WC, waist circumference; FBG, fasting blood glucose.
Figure 3
Figure 3
Risk of COVID-19 according to the components of metabolic syndrome. The risk of COVID-19 infection increased in the patients according to the number of metabolic components. COVID-19, coronavirus disease
See this image and copyright information in PMC

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