Abstract
Background: The prevalence and prognostic implications of metabolic syndrome (MetS) in patients infected by the SARS-CoV-2 remain unclear. We performed a systematic review and meta-analysis of prevalence and mortality risk in COVID-19 patients with MetS. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate every article published up to 1 September 2021, reporting data on MetS among COVID-19 patients. The pooled prevalence of MetS was calculated using a random effects model and presented using the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random effects models with odds ratio (OR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I2 statistic. Results: Six studies, enrolling 209.569 COVID-19 patients [mean age 57.2 years, 114.188 males (54.4%)] met the inclusion criteria and were included in the final analysis. The pooled prevalence of dyslipidaemia was 20.5% of cases (95% CI: 6.7–47.8%, p = 0.03), with high heterogeneity (I2 = 98.9%). Pre-existing MetS was significantly associated with higher risk of short-term mortality (OR: 2.30, 95% CI: 1.52–3.45, p < 0.001), with high heterogeneity (I2 = 89.4%). Meta-regression showed a direct correlation with male gender (p = 0.03), hypertension (p < 0.001), DM (p = 0.01) and hyperlipidaemia (p = 0.04), but no effect when considering age (p = 0.75) and chronic pulmonary disease (p = 0.86) as moderators. Conclusions: MetS represents a major comorbidity in about 20% of COVID-19 patients and it is associated with a 230% increased risk of short-term mortality.
Highlights
Since the beginning of COVID-19 outbreak, a growing body of evidence has demonstrated that clinical outcomes in patients with SARS-CoV-2 infection are closely related to the burden of associated comorbidities [1], such as arterial hypertension (HT), diabetes mellitus (DM) and cardiovascular disease (CVDs) [2,3,4,5]
Most of these concomitant diseases constitute the definition of metabolic syndrome (MetS), a frequent metabolic disorder in the general population, which is commonly considered as a risk factor for the progression of CVDs and type 2 diabetes [6]
Some recent analyses have investigated the role of MetS in COVID-19 patients, a comprehensive assessment of data regarding the real prevalence and prognostic role of MetS in SARS-CoV-2 infected individuals has not yet been performed
Summary
Since the beginning of COVID-19 outbreak, a growing body of evidence has demonstrated that clinical outcomes in patients with SARS-CoV-2 infection are closely related to the burden of associated comorbidities [1], such as arterial hypertension (HT), diabetes mellitus (DM) and cardiovascular disease (CVDs) [2,3,4,5]. Most of these concomitant diseases constitute the definition of metabolic syndrome (MetS), a frequent metabolic disorder in the general population, which is commonly considered as a risk factor for the progression of CVDs and type 2 diabetes [6]. The aim of the present study is to estimate the pooled prevalence and the influence of MetS on short-term mortality in COVID-19 patients by a systematic review and meta-analysis of the available data.
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