Metabolic Syndrome and COVID-19 Mortality Among Adult Black Patients in New Orleans

• Published in: Diabetes care Vol. 44; no. 1; pp. 188 - 193
• Main Authors: Xie, John, Zu, Yuanhao, Alkhatib, Ala, Pham, Thaidan T, Gill, Frances, Jang, Albert, Radosta, Stella, Chaaya, Gerard, Myers, Leann, Zifodya, Jerry S, Bojanowski, Christine M, Marrouche, Nassir F, Mauvais-Jarvis, Franck, Denson, Joshua L
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.01.2021
• Subjects: Biomarkers; Cardiovascular and Metabolic Risk; Clustering; Coronaviruses; COVID-19; Diabetes; Diabetes mellitus; Hospitalization; Hypertension; Inflammation; L-Lactate dehydrogenase; Lactate dehydrogenase; Lactic acid; Mechanical ventilation; Metabolic disorders; Metabolic syndrome; Mortality; Obesity; Research design; Ventilation; Viral diseases
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc20-1714

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. 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. 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]). 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.