Metabolic Syndrome and COVID-19; Clinical Complications and Challenges

10.22122/jims.v38i607.13498

Abstract

Hypertension, insulin resistance, hypertriglyceridemia, decreased high-density lipoprotein (HDL) level, and visceral obesity are the main indexes of metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur together and increase the risk of cardiovascular diseases and mortality. Nowadays, metabolic syndrome has become a global epidemic and approximately 20-25 percent of the world's adult population possess the potential risk factors for developing this disorder. Several studies have shown that patients with various metabolic disorders such as obesity, diabetes, hypertension, and cardiovascular diseases are more susceptible to coronavirus disease 2019 (COVID-19). Furthermore, patients with underlying conditions associated with metabolic syndrome are at higher risk for complications and mortality of COVID-19. Therefore, understanding the mechanisms underlying the cross-talk between COVID-19 and metabolic syndrome are necessary for better management of the affected patients. The aim of the current review was to review any correlation between metabolic syndrome and the COVID-19 infection in terms of the severity in clinical complications and mortality.

Keywords


Khoshdel-Rad N, Zahmatkesh E, Shpichka A, Timashev P, Vosough M. Outbreak of chronic renal failure: Will this be a delayed heritage of COVID-19? J Nephrol 2021; 34(1): 3-5.
Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, et al. Virology, epidemiology, pathogenesis, and control of COVID-19. Viruses 2020; 12(4): 372.
Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr 2020; 14(4): 535-45.
Hu Y, Sun J, Dai Z, Deng H, Li X, Huang Q, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Virol 2020; 127: 104371.
Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res 2020; 24: 91-8.
Baradaran Ghavami SH, Shahrokh SH, Hossein-Khannazer N, Shpichka A, Asadzadeh AH, Timashev P, et al. IBD patients could be silent carriers for novel coronavirus and less prone to its severe adverse events: True or false? Cell J 2020; 22(Suppl 1): 151-4.
Shpichka A, Bikmulina P, Peshkova M, Kosheleva N, Zurina I, Zahmatkesh E, et al. Engineering a model to study viral infections: bioprinting, microfluidics, and organoids to defeat coronavirus disease 2019 (COVID-19). Int J Bioprint 2020; 6(4): 302.
Sardu C, Gambardella J, Morelli MB, Wang X, Marfella R, Santulli G. Hypertension, thrombosis, kidney failure, and diabetes: Is COVID-19 an endothelial disease? A comprehensive evaluation of clinical and basic evidence. J Clin Med 2020; 9(5): 1417.
Costa FF, Rosario WR, Ribeiro Farias AC, de Souza RG, Duarte Gondim RS, Barroso WA. Metabolic syndrome and COVID-19: An update on the associated comorbidities and proposed therapies. Diabetes Metab Syndr 2020; 14(5): 809-14.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020; 395(10229): 1054-62.
Ramezankhani R, Solhi R, Memarnejadian A, Nami F, Hashemian SMR, Tricot T, et al. Therapeutic modalities and novel approaches in regenerative medicine for COVID-19. Int J Antimicrob Agents 2020; 56(6): 106208.
International Diabetes Federation Press Conference: The IDF consensus worldwide definition of the metabolic syndrome [Online]. [cited 2005 Apr 14]; Available from: URL: http://www.idf.org/webdata/docs/IDF_Metasyndrome_definition.pdf
International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome [Online]. [cited 2017 May]; Available from: URL: http://www.idf.org/webdata/docs/mets_def_update2006.pdf
Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365(9468): 1415-28.
Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech 2009; 2(5-6): 231-7.
Garg S, Kim L, Whitaker M, O'Halloran A, Cummings C, Holstein R, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2. MMWR Morb Mortal Wkly Rep 2020; 69(15): 458-64.
Remuzzi A, Remuzzi G. COVID-19 and Italy: What next? Lancet 2020; 395(10231): 1225-8.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020; 382(13): 1199-207.
Jin JM, Bai P, He W, Wu F, Liu XF, Han DM, et al. Gender differences in patients with covid-19: focus on severity and mortality. Front Public Health 2020; 8: 152.
Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018; 12(9): 755-67.
Zhang X, Zheng J, Zhang L, Liu Y, Chen GP, Zhang HP, et al. Systemic inflammation mediates the detrimental effects of obesity on asthma control. Allergy Asthma Proc 2017.
Petrakis D, Margina D, Tsarouhas K, Tekos F, Stan M, Nikitovic D, et al. Obesity a risk factor for increased COVID19 prevalence, severity and lethality (Review). Mol Med Rep 2020; 22(1): 9-19.
Peters MC, McGrath KW, Hawkins GA, Hastie AT, Levy BD, Israel E, et al. Plasma interleukin-6 concentrations, metabolic dysfunction, and asthma severity: A cross-sectional analysis of two cohorts. Lancet Respir Med 2016; 4(7): 574-84.
Gomez R, Lago F, Gomez-Reino J, Dieguez C, Gualillo O. Adipokines in the skeleton: influence on cartilage function and joint degenerative diseases. J Mol Endocrinol 2009; 43(1): 11-8.
Gomez R, Conde J, Scotece M, Gomez-Reino JJ, Lago F, Gualillo O. What's new in our understanding of the role of adipokines in rheumatic diseases? Nat Rev Rheumatol 2011; 7(9): 528-36.
Sanna V, Di GA, La CA, Lechler RI, Fontana S, Zappacosta S, et al. Leptin surge precedes onset of autoimmune encephalomyelitis and correlates with development of pathogenic T cell responses. J Clin Invest 2003; 111(2): 241-50.
Leisegang K, Sengupta P, Agarwal A, Henkel R. Obesity and male infertility: Mechanisms and management. Andrologia 2021; 53(1): e13617.
Flehmig G, Scholz M, Kloting N, Fasshauer M, Tonjes A, Stumvoll M, et al. Identification of adipokine clusters related to parameters of fat mass, insulin sensitivity and inflammation. PLoS One 2014; 9(6): e99785.
Patel SB, Reams GP, Spear RM, Freeman RH, Villarreal D. Leptin: Linking obesity, the metabolic syndrome, and cardiovascular disease. Curr Hypertens Rep 2008; 10(2): 131-7.
Sun Y, Wang Q, Yang G, Lin C, Zhang Y, Yang P. Weight and prognosis for influenza A(H1N1)pdm09 infection during the pandemic period between 2009 and 2011: A systematic review of observational studies with meta-analysis. Infect Dis (Lond) 2016; 48(11-12): 813-22.
Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Requiring invasive mechanical ventilation. Obesity (Silver Spring) 2020; 28(7): 1195-9.
Jia X, Yin C, Lu S, Chen Y, Liu Q, Bai J, Lu Y. Two things about COVID-19 might need attention. Preprints 2020: 2020020315.
Chen Q, Zheng Z, Zhang C, Zhang X, Wu H, Wang J, et al. Clinical characteristics of 145 patients with corona virus disease 2019 (COVID-19) in Taizhou, Zhejiang, China. Infection 2020; 48(4): 543-51.
Caussy C, Pattou F, Wallet F, Simon C, Chalopin S, Telliam C, et al. Prevalence of obesity among adult inpatients with COVID-19 in France. Lancet Diabetes Endocrinol 2020; 8(7): 562-4.
Petrilli C, Jones S, Yang J, Rajagopalan H, O'Donnell L, Chernyak Y, et al. Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. medRxiv 2020.
Liu M, He P, Liu HG, Wang XJ, Li FJ, Chen S, et al. Clinical characteristics of 30 medical workers infected with new coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za Zhi 2020; 43(0): E016. [In Chinese].
Lighter J, Phillips M, Hochman S, Sterling S, Johnson D, Francois F, et al. Obesity in patients younger than 60 years is a risk factor for COVID-19 hospital admission. Clin Infect Dis 2020; 71(15): 896-7.
Peng YD, Meng K, Guan HQ, Leng L, Zhu RR, Wang BY, et al. Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48(6): 450-5. [In Chinese].
Diez JJ, Iglesias P. The role of the novel adipocyte-derived hormone adiponectin in human disease. Eur J Endocrinol 2003; 148(3): 293-300.
Reaven GM, Hollenbeck C, Jeng CY, Wu MS, Chen YD. Measurement of plasma glucose, free fatty acid, lactate, and insulin for 24 h in patients with NIDDM. Diabetes 1988; 37(8): 1020-4.
Steinberg HO, Tarshoby M, Monestel R, Hook G, Cronin J, Johnson A, et al. Elevated circulating free fatty acid levels impair endothelium-dependent vasodilation. J Clin Invest 1997; 100(5): 1230-9.
Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, et al. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes Care 2020; 43(7): 1392-8.
Tol A, Alhani F, Shojaeazadeh D, Sharifirad G. Empowerment approach to promote quality of life and self- management among type 2 diabetic patients. J Health Syst Res 2011; 7(2): 157-68. [In Persian].
Chan WM, Woo J, Hui E, Lau WW, Lai JC, Lee D. A community model for care of elderly people with diabetes via telemedicine. Appl Nurs Res 2005; 18(2): 77-81.
Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr 2020; 14(4): 303-10.
Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev 2020; e3319. [Epub ahead of print].
Angelidi AM, Belanger MJ, Mantzoros CS. Commentary: COVID-19 and diabetes mellitus: What we know, how our patients should be treated now, and what should happen next. Metabolism 2020; 107: 154245.
Allard R, Leclerc P, Tremblay C, Tannenbaum TN. Diabetes and the severity of pandemic influenza A (H1N1) infection. Diabetes Care 2010; 33(7): 1491-3.
Dodek P. Diabetes and other comorbid conditions were associated with a poor outcome in SARS. ACP Journal Club 2004; 140(1): 19.
Matsuyama R, Nishiura H, Kutsuna S, Hayakawa K, Ohmagari N. Clinical determinants of the severity of Middle East respiratory syndrome (MERS): A systematic review and meta-analysis. BMC Public Health 2016; 16(1): 1203.
Yang JK, Feng Y, Yuan MY, Yuan SY, Fu HJ, Wu BY, et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabet Med 2006; 23(6): 623-8.
Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: A systematic review and meta-analysis. Int J Infect Dis 2020; 94: 91-5.
Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A. COVID-19 infection may cause ketosis and ketoacidosis. Diabetes Obes Metab 2020; 22(10): 1935-41.
Gupta R, Ghosh A, Singh AK, Misra A. Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes Metab Syndr 2020; 14(3): 211-2.
Kreutz R, Algharably EAE, Azizi M, Dobrowolski P, Guzik T, Januszewicz A, et al. Hypertension, the renin-angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19. Cardiovasc Res 2020; 116(10): 1688-99.
Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr 2020; 14(3): 247-50.
Zheng Y, Xu H, Yang M, Zeng Y, Chen H, Liu R, et al. Epidemiological characteristics and clinical features of 32 critical and 67 noncritical cases of COVID-19 in Chengdu. J Clin Virol 2020; 127: 104366.
Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020; 5(7): 811-8.
Lippi G, Wong J, Henry BM. Hypertension in patients with coronavirus disease 2019 (COVID-19): A pooled analysis. Pol Arch Intern Med 2020; 130(4): 304-9.
Gradinaru D, Margina D, Borsa C, Ionescu C, Ilie M, Costache M, et al. Adiponectin: possible link between metabolic stress and oxidative stress in the elderly. Aging Clin Exp Res 2017; 29(4): 621-9.
Berzins SP, Uldrich AP, Sutherland JS, Gill J, Miller JF, Godfrey DI, et al. Thymic regeneration: Teaching an old immune system new tricks. Trends Mol Med 2002; 8(10): 469-76.
Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol 2020; 92(4): 441-7.
Majumder MS, Mandl KD. Early transmissibility assessment of a novel coronavirus in Wuhan, China. SSRN 2020; 3524675.
Read J, Bridgen J, Cummings D, Ho A, Jewell C. Novel coronavirus 2019-nCoV: Early estimation of epidemiological parameters and epidemic predictions. medRxiv 2020.
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8(5): 475-81.
Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol 2020; 109(5): 531-8.
Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of underlying diseases in hospitalized patients with COVID-19: A systematic review and meta-analysis. Arch Acad Emerg Med 2020; 8(1): e35.
Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: A nationwide analysis. Eur Respir J 2020; 55(5): 2000547.
Zhang M, Wang B, Liu Y, Sun X, Luo X, Wang C, et al. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study. Cardiovasc Diabetol 2017; 16(1): 30.
Sanchez-Inigo L, Navarro-Gonzalez D, Pastrana-Delgado J, Fernandez-Montero A, Martinez JA. Association of triglycerides and new lipid markers with the incidence of hypertension in a Spanish cohort. J Hypertens 2016; 34(7): 1257-65.
Zhang S, Du T, Zhang J, Lu H, Lin X, Xie J, et al. The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease. Lipids Health Dis 2017; 16(1): 15.
Wei X, Zeng W, Su J, Wan H, Yu X, Cao X, et al. Hypolipidemia is associated with the severity of COVID-19. J Clin Lipidol 2020; 14(3): 297-304.
Baker J, Ayenew W, Quick H, Hullsiek KH, Tracy R, Henry K, et al. High-density lipoprotein particles and markers of inflammation and thrombotic activity in patients with untreated HIV infection. J Infect Dis 2010; 201(2): 285-92.
Rose H, Hoy J, Woolley I, Tchoua U, Bukrinsky M, Dart A, et al. HIV infection and high density lipoprotein metabolism. Atherosclerosis 2008; 199(1): 79-86.
Cao WJ, Wang TT, Gao YF, Wang YQ, Bao T, Zou GZ. Serum lipid metabolic derangement is associated with disease progression during chronic HBV infection. Clin Lab 2019; 65(12): 190525.
Wang G, Zhang Q, Zhao X, Dong H, Wu C, Wu F, et al. Low high-density lipoprotein level is correlated with the severity of COVID-19 patients: An observational study. Lipids Health Dis 2020; 19(1): 204.
Taborda NA, Blanquiceth Y, Urcuqui-Inc, Latz E, Hernandez JC. High-density lipoproteins decrease proinflammatory activity and modulate the innate immune response. J Interferon Cytokine Res 2019; 39(12): 760-70.
Murphy AJ, Woollard KJ, Suhartoyo A, Stirzaker RA, Shaw J, Sviridov D, et al. Neutrophil activation is attenuated by high-density lipoprotein and apolipoprotein A-I in in vitro and in vivo models of inflammation. Arterioscler Thromb Vasc Biol 2011; 31(6): 1333-41.
Thacker SG, Zarzour A, Chen Y, Alcicek MS, Freeman LA, Sviridov DO, et al. High-density lipoprotein reduces inflammation from cholesterol crystals by inhibiting inflammasome activation. Immunology 2016; 149(3): 306-19.
Zewinger S, Drechsler C, Kleber ME, Dressel A, Riffel J, Triem S, et al. Serum amyloid A: High-density lipoproteins interaction and cardiovascular risk. Eur Heart J 2015; 36(43): 3007-16.
Han CY, Tang C, Guevara ME, Wei H, Wietecha T, Shao B, et al. Serum amyloid A impairs the antiinflammatory properties of HDL. J Clin Invest 2016; 126(1): 266-81.
Hu X, Chen D, Wu L, He G, Ye W. Declined serum high density lipoprotein cholesterol is associated with the severity of COVID-19 infection. Clin Chim Acta 2020; 510: 105-10.
Wei C, Wan L, Zhang Y, Fan C, Yan Q, Yang X, et al. Cholesterol metabolism--Impact for SARS-CoV-2 infection prognosis, entry, and antiviral therapies. medRxiv 2020.
Ren H, Yang Y, Wang F, Yan Y, Shi X, Dong K, et al. Association of the insulin resistance marker TyG index with the severity and mortality of COVID-19. Cardiovasc Diabetol 2020; 19(1): 58.
Fulzele S, Sahay B, Yusufu I, Lee TJ, Sharma A, Kolhe R, et al. COVID-19 virulence in aged patients might be impacted by the host cellular microRNAs abundance/profile. Aging Dis 2020; 11(3): 509-22.
Chatterjee P, Nagi N, Agarwal A, Das B, Banerjee S, Sarkar S, et al. The 2019 novel coronavirus disease (COVID-19) pandemic: A review of the current evidence. Indian J Med Res 2020; 151(2-3): 147-59.
Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020; 180(7): 934-43.
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a Report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323(13): 1239-42.