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COVID-19 Risk and Metabolic Syndrome

The U.S. Centers for Disease Control has stated that people with underlying conditions such as cancer, chronic kidney disease, or serious heart conditions appear to fare worse when infected COVID-19. Now new research shows how much of an impact a cluster of health issues known as metabolic syndrome can also have on patient outcomes.

Patients who had metabolic syndrome were more than three times more likely to die from COVID-19 than those who did not have metabolic syndrome in a new study published in the journal Diabetes Care.

Metabolic syndrome is a combination of at least three of five conditions:

  • Obesity
  • High blood pressure
  • Prediabetes or diabetes
  • High triglycerides
  • Low HDL “good” cholesterol

Researchers collected data from 287 predominantly Black patients with COVID-19 who were hospitalized at two hospitals in New Orleans between March 30 and April 5, 2020. Metabolic syndrome was present in 66 percent of the patients. Not only was it significantly associated with mortality, but it was also linked to intensive care, the need for a ventilator, and acute respiratory distress syndrome (ARDS), a life-threatening condition in which fluid leaks into the lungs.

The average age of people in the study was 61, and nearly 57 percent were women.

Of the patients with metabolic syndrome:

  • 26% died due to COVID-19 (vs. 10% of patients without metabolic syndrome)
  • 56% needed intensive care (vs. 24% of patients without metabolic syndrome)
  • 48% needed ventilation (vs. 18% of patients without metabolic syndrome)
  • 37% developed ARDS (vs. 11% of patients without metabolic syndrome)

Even after adjusting for several variables like age, sex, race, and hospital location, patients with metabolic syndrome were 3.4 times more likely to die from COVID-19 than patients without metabolic syndrome.

While being obese or having diabetes was linked to a greater risk of ICU admission and needing ventilation, the researchers did not observe an increase in mortality when observing only one of the conditions clustered with metabolic syndrome alone.

“This suggests that metabolic syndrome should be considered a composite predictor of COVID-19 lethal outcome, increasing the odds of mortality by the combined effects of its individual components,” note the researchers.

Because this was a retrospective observational study, the conclusions can only be based on association and do not prove causation.

Still, the researchers note that the underlying inflammation involved with metabolic syndrome could be what is leading to more severe cases in these patients.

“The chronic low-grade systemic inflammation that characterizes individuals with metabolic syndrome may provide a permissive inflammatory environment that intensifies the evolution toward ARDS and death,” note the researchers. “Further research into the underlying mechanisms by which metabolic syndrome increases COVID-19 mortality is needed.”

Up to one third of American adults have metabolic syndrome, and it is increasingly common, per the Mayo Clinic. Lifestyle changes like a healthy diet and exercise can delay or prevent the development of critical health issues if you have metabolic syndrome.

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Acute Respiratory Distress Syndrome (ARDS). American Lung Association. September 2, 2020. https://www.lung.org/lung-health-diseases/lung-disease-lookup/ards.

People with Certain Medical Conditions. Coronavirus Disease 2019 (COVID-19). U.S. Centers for Disease Control and Prevention. August 14, 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html.

Xie J, et al. Metabolic Syndrome and COVID-19 Mortality Among Adult Black Patients in New Orleans. Diabetes Care. August 25, 2020. doi: https://doi.org/10.2337/dc20-1714.

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