American Diabetes Association
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Metabolic Syndrome and COVID-19 Mortality among Adult Black Patients in New Orleans

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posted on 2020-08-25, 15:21 authored by John Xie, Yuanhao Zu, Ala Alkhatib, Thaidan T Pham, Frances Gill, Albert Jang, Stella Radosta, Gerard Chaaya, Leann Myers, Jerry S. Zifodya, Christine M. Bojanowski, Nassir F. Marrouche, Franck Mauvais-Jarvis, Joshua L. Denson
OBJECTIVE Coronavirus disease 2019 (COVID-19) mortality is high in patients with hypertension, obesity and diabetes mellitus. We examined the association between hypertension, obesity and diabetes, individually and clustered as metabolic syndrome (MetS), and COVID-19 outcomes in patients hospitalized in New Orleans during the peak of the outbreak.

RESEARCH DESIGN AND METHODS Data were collected from 287 consecutive COVID-19 patients hospitalized at two hospitals in New Orleans, Louisiana from March 30th to April 5th, 2020. MetS was identified per WHO criteria.

RESULTS Among 287 patients (mean age, 61.5 years; female, 56.8%; non-Hispanic Black, 85.4%), MetS was present in 188 (66%). MetS was significantly associated with mortality (adjusted odds ratio [aOR]: 3.42, 95% confidence interval [CI]: 1.52-7.69), ICU (aOR: 4.59, CI: 2.53-8.32), invasive mechanical ventilation (IMV) (aOR: 4.71, CI: 2.50-8.87) and acute respiratory distress syndrome (ARDS) (aOR: 4.70, CI: 2.25-9.82), compared with non-MetS. Multivariable analyses of hypertension, obesity and diabetes individually showed no association with mortality. Obesity was associated with ICU (aOR, 2.18, CI, 1.25-3.81), ARDS (aOR, 2.44, CI, 1.28-4.65), and IMV (aOR, 2.36, CI, 1.33-4.21). Diabetes was associated with ICU (aOR, 2.22, CI, 1.24-3.98) and IMV (aOR, 2.12, CI, 1.16-3.89). Hypertension was not significantly associated with any outcome. Inflammatory biomarkers associated with MetS, C-reactive protein (CRP) and lactate dehydrogenase (LDH) were associated with mortality [CRP (aOR, 3.66, CI, 1.22-10.97), LDH (aOR, 3.49, CI, 1.78-6.83)].

CONCLUSIONS In predominantly Black patients hospitalized for COVID-19, the clustering of hypertension, obesity and diabetes as MetS increased the odds of mortality compared to these comorbidities individually.


Funding for this work was provided in part by the Tulane University Physician Scientist Pipeline Program (JLD), American Diabetes Association grant #7-20-COVID-053 (JLD) and #7-20-COVID-051 (FMJ), NIGMS/NIH award U54 GM104940 which funds the Louisiana Clinical and Translational Science Center (JLD), National Institutes of Health [awards DK074970 and DK107444 (FMJ)], and the U.S. Department of Veterans Affairs Merit Review Award BX003725 (FMJ).


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