DALLAS, Texas – Hospitalized COVID-19 patients who had combinations of high blood pressure, obesity, diabetes and/or high cholesterol associated with metabolic syndrome were at a much higher risk of acute respiratory distress syndrome (ARDS) and death, according to an international study in JAMA Network Open, an international, peer-reviewed, open-access general medical journal published by the American Medical Association.
The risk for developing ARDS, a life-threatening lung condition, grew progressively higher with each additional metabolic syndrome condition. The study, one of the largest to examine the link between metabolic syndrome and outcomes for COVID-19, examined the hospitalizations of more than 46,000 patients admitted in 181 hospitals across 26 countries.
"Our study found that if you have high cholesterol, high blood pressure, mild obesity and pre-diabetes or diabetes and are hospitalized with COVID-19, you have a 1 in 4 chance of developing ARDS, which is significant," said lead author of the study Joshua Denson, MD, pulmonary and critical care medicine physician and assistant professor of medicine at Tulane University School of Medicine.
Valerie Danesh, Ph.D., RN, FAAN, a Baylor Scott & White research investigator, was among the study's authors. "The frequency of ARDS increased with the number of metabolic risk factors," Dr. Danesh said. "Our community should know that, in our study, hospitalized patients with fewer metabolic risk factors had lower odds of requiring mechanical ventilation in an ICU."
The researchers defined metabolic syndrome as having more than three of the following criteria: obesity, pre-diabetes or diabetes, hypertension and high cholesterol. Patients with metabolic syndrome were 36% more likely to develop ARDS and almost 20% more likely to die in the hospital.
According to the Centers for Disease Control and Prevention, more than a third of adults in the U.S. meet the criteria for metabolic syndrome.
In the study, the rates of metabolic syndrome were nearly doubled among hospitalized patients in the U.S. compared with hospitalized patients outside of the U.S. The researchers note that given the high rates of metabolic syndrome, obesity and diabetes in the U.S., one hypothesis for why the U.S. leads the world in COVID-19 cases and deaths could be its high prevalence of metabolic syndrome.
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