Abstract
Recent studies showed that comorbidities such as diabetes, hypertension and obesity contribute to severe and worse outcomes of coronavirus disease 2019 (COVID-19), suggesting that metabolic syndrome and its components are associated with severity of COVID-19. Here, I systematically reviewed a possible association of metabolic syndrome with the susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severity of COVID-19 by literature search. A population-based study and UK Biobank studies showed that patients with metabolic syndrome is highly susceptible to SARS-CoV-2 infection. Recent meta-analyses showed that metabolic syndrome is significantly associated with the development of severe COVID-19. Angiotensin-converting enzyme (ACE) 2 is the cellular entry receptor of SARS-CoV-2. Enhanced ACE2 expression, pre-existing endothelial dysfunction and procoagulant state induced by adipocytokines dysregulation in metabolic syndrome may play a crucial role for the development of severe COVID-19.
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