Diabetes Metab J.  2022 May;46(3):427-438. 10.4093/dmj.2021.0105.

Association of Metabolic Syndrome with COVID-19 in the Republic of Korea

• Jeon WH
• Seon JY
• Park SY
• Oh IH

• KMID: 2530182
• DOI: http://doi.org/10.4093/dmj.2021.0105

Abstract

Background
Metabolic syndrome (MetS) is reportedly a crucial risk factor for coronavirus disease 2019 (COVID-19). Since the epidemiological studies that examine this association are few and include small samples, we investigated the relationship between MetS and COVID-19 severity and death using a larger sample in the Republic of Korea.
Methods
We analyzed 66,321 patients, 4,066 of whom had COVID-19. We used chi-square tests to examine patients’ characteristics. We performed logistic regression analysis to analyze differences in COVID-19 infection and clinical outcomes according to the presence of MetS.
Results
Although MetS was not significantly associated with COVID-19 risk, acquiring MetS was significantly associated with the risk of severe COVID-19 outcomes (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.34 to 2.91; P=0.001). The mortality risk was significantly higher in COVID-19 patients with MetS (OR, 1.74; 95% CI, 1.17 to 2.59; P=0.006). Patients with abnormal waist circumference were approximately 2.07 times more likely to develop severe COVID-19 (P<0.001), and high-density lipoprotein cholesterol (HDL-C) levels were significantly associated with COVID-19; the mortality risk due to COVID-19 was 1.74 times higher in men with an HDL-C level of <40 mg/dL and in women with an HDL-C level of <50 mg/dL (P=0.012).
Conclusion
COVID-19 is likely associated with severity and death in patients with MetS or in patients with MetS risk factors. Therefore, patients with MetS or those with abnormal waist circumference and HDL-C levels need to be treated with caution.

Keyword

COVID-19; Metabolic syndrome; Risk factors

Figure

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  Fig. 1. Flowchart of the patient selection process. We selected 66,321 patients who were enrolled in the National Health Insurance Service (NHIS) and excluded those with missing records. Among the selected patients, 62,255 were non-coronavirus disease 2019 (COVID-19) patients, while 4,066 were COVID-19 patients.

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