Metabolic Syndrome and COVID-19 Mortality Among Adult Black Patients in New Orleans
John Xie1, Yuanhao Zu2, Ala Alkhatib1
1Section of Pulmonary Diseases, Critical Care and Environmental Medicine, John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA.
Insights
Metabolic syndrome (MetS) significantly increased COVID-19 mortality risk in hospitalized patients. Clustering hypertension, obesity, and diabetes as MetS, rather than individually, heightened the odds of death and severe outcomes.
Area of Science:
- Infectious Diseases
- Cardiovascular Medicine
- Endocrinology
Background:
- High COVID-19 mortality observed in patients with hypertension, obesity, and diabetes.
- Metabolic syndrome (MetS) represents a clustering of these common comorbidities.
Purpose of the Study:
- To examine the association between MetS and COVID-19 outcomes.
- To compare the impact of individual comorbidities versus clustered MetS on COVID-19 severity.
Main Methods:
- Retrospective analysis of 287 COVID-19 patients hospitalized in New Orleans.
- MetS identified using World Health Organization criteria.
- Multivariable logistic regression to assess associations with mortality, ICU admission, invasive mechanical ventilation, and ARDS.
Main Results:
- MetS was present in 66% of patients and significantly associated with increased mortality (aOR 3.42), ICU admission (aOR 4.59), invasive mechanical ventilation (aOR 4.71), and ARDS (aOR 4.70).
- Individual comorbidities (hypertension, obesity, diabetes) showed weaker or no significant associations with mortality, though obesity and diabetes were linked to ICU admission and ventilation.
- Elevated inflammatory biomarkers (CRP, LDH) associated with MetS also correlated with mortality.
Conclusions:
- In this cohort of predominantly Black patients hospitalized with COVID-19, metabolic syndrome significantly increased the risk of mortality and severe outcomes.
- The clustering of hypertension, obesity, and diabetes into MetS demonstrated a stronger association with adverse COVID-19 outcomes than individual conditions.
Objective:
Coronavirus disease 2019 (COVID-19) mortality is high in patients with hypertension, obesity, and diabetes. We examined the association between hypertension, obesity, and diabetes, individually and clustered as metabolic syndrome (MetS), and COVID-19 outcomes in patients hospitalized in New Orleans during the peak of the outbreak.
Research Design And Methods:
Data were collected from 287 consecutive patients with COVID-19 hospitalized at two hospitals in New Orleans, LA from 30 March to 5 April 2020. MetS was identified per World Health Organization criteria.
Results:
Among 287 patients (mean age 61.5 years; female, 56.8%; non-Hispanic black, 85.4%), MetS was present in 188 (66%). MetS was significantly associated with mortality (adjusted odds ratio [aOR] 3.42 [95% CI 1.52-7.69]), intensive care unit (ICU) (aOR 4.59 [CI 2.53-8.32]), invasive mechanical ventilation (IMV) (aOR 4.71 [CI 2.50-8.87]), and acute respiratory distress syndrome (ARDS) (aOR 4.70 [CI 2.25-9.82]) compared with non-MetS. Multivariable analyses of hypertension, obesity, and diabetes individually showed no association with mortality. Obesity was associated with ICU (aOR 2.18 [CI, 1.25-3.81]), ARDS (aOR 2.44 [CI 1.28-4.65]), and IMV (aOR 2.36 [CI 1.33-4.21]). Diabetes was associated with ICU (aOR 2.22 [CI 1.24-3.98]) and IMV (aOR 2.12 [CI 1.16-3.89]). Hypertension was not significantly associated with any outcome. Inflammatory biomarkers associated with MetS, CRP, and lactate dehydrogenase (LDH) were associated with mortality (CRP [aOR 3.66] [CI 1.22-10.97] and LDH [aOR 3.49] [CI 1.78-6.83]).
Conclusions:
In predominantly black patients hospitalized for COVID-19, the clustering of hypertension, obesity, and diabetes as MetS increased the odds of mortality compared with these comorbidities individually.
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