Visual Abstract

Purpose: Characterize association between metabolic syndrome (MS) and COVID-19.

Methods: This retrospective study included adult patients who tested for COVID-19 between March 8 and May 17, 2020. Demographics, labs, hospitalization, ICU admission, and mortality were analyzed with SAS. Groups were defined by MS according to NCEP/ATP criteria and serum AST:ALT, TG:HDL, and uric acid.

Results: Of 23282 tested patients, 3679 (16%) were COVID-positive. MS was present in 834 (39%) of 2146 positive patients with available data. Patients with MS were older, male, Black, heavier, and had more comorbidities. MS was associated with higher rates of hospital admission and death (p<0.001). On multivariable analysis, patients with MS had increased risk of hospitalization (77%), ICU admission (57%) and death (81%) relative to those without MS (p<0.001). After adjusting for age, sex, race and comorbidities, MS remained a significant predictor of outcomes. AST:ALT>1 was a predictor of hospital and ICU admission, but not mortality. Higher TG:HDL ratio and uric acid were associated with worse outcomes, but were not independent predictors.

Conclusion: MS is a significant predictor of hospital and ICU admission and mortality due to COVID-19, even after adjusting for other factors. Targeting modifiable components of MS including obesity, hyperglycemia, and hypertension may reduce mortality from COVID-19.


S. Wu: None. J. F. Bena: None. K. Zhou: None. A. D. Misra-hebert: None. S. Kashyap: Advisory Panel; Self; Fractyl Laboratories, Inc., GI Dynamics.

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