Association between metabolic syndrome and mortality in patients with COVID-19: A nationwide cohort study

Abstract

Objectives: We investigated the association between metabolic syndrome (MetS) and mortality among corona -virus disease 2019 (COVID-19) patients in Korea. Methods: We analyzed 3876 individuals aged >= 20 years who were confirmed with COVID-19 from January 1 to June 4, 2020 based on the Korea National Health Insurance Service (NHIS)-COVID-19 database and had un-dergone health examination by NHIS between 2015 and 2017. Multivariable Cox proportional hazard regression analyses were performed. Results: Of total participants, the prevalence of MetS was 21.0% (n = 815). During 58.6 days of mean follow-up, 3.1 % (n = 120) of the participants died. Compared to individuals without MetS, COVID-19 patients with MetS had a significantly increased mortality risk after adjusting for confounders in total participants (hazard ratio [HR]: 1.68, 95 % confidence interval [CI]: 1.14-2.47) and women (HR: 2.41, 95 % CI: 1.17-4.96). A low high -density lipoprotein cholesterol level in total participants (HR: 1.63, 95 % CI: 1.12-2.37) and hyperglycemia in women (HR: 1.97, 95 % CI: 1.01-3.84) was associated with higher mortality risk. The mortality risk increased as the number of MetS components increased among total participants and women (P for trend = 0.009 and 0.016, respectively). In addition, MetS groups had higher mortality risk in aged >= 60 years (HR: 1.60, 95 % CI: 1.07-2.39), and never-smokers (2.08, 1.21-3.59). Conclusions: The presence of MetS and greater number of its components were associated with increased mor-tality risks particularly in female patients with COVID-19. Managing MetS may contribute to better outcomes of COVID-19.