Metabolic Syndrome and ARDS in COVID-19
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Pulmonary, Infection, Endocrine, 2022
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INTRODUCTION/HYPOTHESIS: Little is known about metabolic syndrome (MetS) and ARDS in COVID-19. We hypothesized MetS was associated with ARDS from COVID-19. METHODS: Multicenter observational cohort study of hospitalized adults from the SCCM Discovery VIRUS: COVID-19 Registry from February 15, 2020, to February 18, 2021. Outcomes were compared between patients with MetS (defined as three or more of the following criteria: obesity, prediabetes/diabetes, hypertension, and dyslipidemia) and a control population without MetS. Outcomes included mortality, ARDS, intensive care unit (ICU) admission, and invasive mechanical ventilation (IMV). RESULTS: Among 181 hospitals in 26 countries, 29,040 patients (female, 45.0%; mean age, 61.2 years; Black, 23.4%) met inclusion criteria. MetS, present in 3,993 (13.8%), were compared with Controls (n=25,047, 86.3%). In adjusted analyses, MetS was associated with increased ARDS (aOR 1.54 [CI 1.41-1.68]), mortality (aOR 1.26 [CI 1.15-1.38]), ICU admission (aOR 1.41 [CI 1.31-1.52]), IMV (aOR 1.60 [CI 1.48-1.74]), and increased hospital (median 8.8 vs 6.7, p < 0.001) and ICU (median 7.0 vs. 6.3, p < 0.001) days. With each additional MetS criterion from 0 to 3, the frequency of ARDS increased in an additive fashion (6.6% to 12.4% to 16.3% to 24.9%, respectively, p < 0.001 for all comparisons). Once a patient met criteria for MetS (at least 3 of 4 criteria), the risk for ARDS plateaued (3 of 4 criteria 24.9% and 4 of 4 criteria 24.9%). When compared to International hospitals, US hospitals were burdened with significantly higher proportions of obesity (48.2% vs. 26.4%), prediabetes/DM (33.7% vs. 31.7), HTN (54.8% vs 45.5), and dyslipidemia (11.1% vs 5.3%). However, patients from non-US hospitals had significantly higher hospital mortality as compared with US hospitals (24.5% vs 15.7%, aOR 1.58 [CI 1.41-1.77]) with similar findings noted when patients were stratified by MetS (34.1% vs 21.3%, aOR 1.49 [CI 1.08-2.06]) CONCLUSION AND RELEVANCE: MetS, diagnosed by the clustering of obesity, prediabetes/DM, HTN, and dyslipidemia, is associated with significantly increased mortality and ARDS in a global population of hospitalized COVID-19 patients. This increased risk appears to be cumulative with the proportion of ARDS increasing with each added MetS criteria.
Meta Tag
Content Type Presentation
Knowledge Area Pulmonary
Knowledge Area Infection
Knowledge Area Endocrine
Knowledge Level Intermediate
Knowledge Level Advanced
Membership Level Select
Tag Acute Respiratory Distress Syndrome ARDS
Tag Diabetes
Tag Acute Lung Injury
Tag Obesity
Tag COVID-19
Year 2022
metabolic syndrome


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