USA: Findings from a recent study indicate that in patients hospitalized with COVID-19, metabolic syndrome is tied to an increased risk of acute respiratory distress syndrome (ARDS) and death. The study was published in JAMA Network Open on December 22, 2021.
In patients with severe COVID-19, diabetes, obesity, and hypertension are common comorbidities, yet not much is known about ARDS or death risk in patients with COVID-19 and metabolic syndrome. Joshua L. Denson, Tulane University School of Medicine, New Orleans, Louisiana, and colleagues, therefore, aimed to determine whether the metabolic syndrome is associated with an increased risk of ARDS and death from COVID-19 in a multicenter cohort study.
In the study, data was used from the Society of Critical Care Medicine Discovery Viral Respiratory Illness Universal Study collected from 181 hospitals across 26 countries. The researchers compared data between patients with metabolic syndrome (defined as ≥3 of the following criteria: obesity, prediabetes or diabetes, hypertension, and dyslipidemia) and a control population without metabolic syndrome.
Adult patients hospitalized for COVID-19 during the study period who had a completed discharge status were included. Exposures were SARS-CoV-2 infection, metabolic syndrome, prediabetes or diabetes, obesity, hypertension, and/or dyslipidemia. The primary outcome was in-hospital mortality.
A total of 5069 patients (17.5%) with metabolic syndrome were compared with 23 971 control patients (82.5%) without metabolic syndrome.
The research revealed the following findings:
In adjusted analyses, metabolic syndrome was associated with increased risk of ICU admission (adjusted odds ratio [aOR], 1.32), invasive mechanical ventilation (aOR, 1.45), ARDS (aOR, 1.36), and mortality (aOR, 1.19) and prolonged hospital LOS (median, 8.0 days vs 6.8 days) and ICU LOS (median, 7.0 days vs 6.4 days).
Each additional metabolic syndrome criterion was associated with increased risk of ARDS in an additive fashion (1 criterion: 1147 patients with ARDS [10.4%]; 2 criteria: 1191 patients with ARDS [15.3%]; 3 criteria: 817 patients with ARDS [19.3%]; 4 criteria: 203 patients with ARDS [24.3%]).
"The cohort study including 29 040 adults hospitalized with COVID-19, found that metabolic syndrome, diagnosed by the clustering of obesity, prediabetes or diabetes, hypertension, and dyslipidemia, was associated with significantly increased ARDS and mortality," wrote the authors. "This increased risk was cumulative, with the proportion of ARDS increasing with each added metabolic syndrome criteria."
Reference:
Denson JL, Gillet AS, Zu Y, et al. Metabolic Syndrome and Acute Respiratory Distress Syndrome in Hospitalized Patients With COVID-19. JAMA Netw Open. 2021;4(12):e2140568. doi:10.1001/jamanetworkopen.2021.40568