Metabolic Syndrome and Its Components in Patients with COVID-19: Severe Acute Respiratory Syndrome (SARS) and Mortality. A Systematic Review and Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational cohort studies
PubMed 34940517 · doi:10.3390/jcdd8120162
What was done
A systematic search across multiple databases up to September 1, 2021, identified primary observational longitudinal studies assessing metabolic syndrome and its components in relation to severe acute respiratory syndrome (SARS) and mortality in COVID-19 patients. Two independent reviewers performed screening, data extraction, and Newcastle-Ottawa Scale risk-of-bias assessment. Pooled effect estimates were calculated using random-effects meta-analysis.
What was found
Metabolic syndrome was significantly associated with SARS (pooled OR 3.21, 95% CI: 2.88–3.58; a second reported pooled OR was 2.19, 95% CI: 1.71–2.67, p < 0.001, which was significantly higher than hypertension alone). Metabolic syndrome was also significantly associated with mortality (pooled OR 2.32, 95% CI: 1.16–4.63). For mortality, the pooled OR for metabolic syndrome was numerically higher than for its individual components, but the difference was not statistically significant.
Why it matters
This review highlights that clustered metabolic comorbidities present a greater overall risk for severe COVID-19 manifestations than isolated risk factors, supporting aggressive risk stratification for patients with metabolic syndrome.
Limits
The review relies entirely on observational cohort studies, which are prone to residual confounding. The abstract omits the number of included studies, total participant sample size, heterogeneity metrics, and specific definitions of metabolic syndrome across cohorts. The confidence interval for mortality is broad (OR 1.16–4.63), showing marked imprecision.
Cited by
- supports COVID-19 disproportionately caused severe illness in individuals with metabolic dysfunction.