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Original article
DOI: 10.1016/j.medcli.2021.05.014
Disponible online el 7 de Julio de 2021
Clinical features and prognosis of COVID-19 patients with metabolic syndrome: A multicenter, retrospective study
Características clínicas y pronóstico de los pacientes con COVID-19 y síndrome metabólico: un estudio multicéntrico y retrospectivo
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Jian Wanga,1, Li Zhub,1, Longgen Liuc,1, Xuebing Yand,1, Leyang Xuee,1, Songping Huangf, Biao Zhangg, Tianmin Xuc, Fang Jid, Chunyang Lid, Fang Mingf, Yun Zhaoh, Juan Chengi, Kang Chenj, Xiang-an Zhaok, Dawen Sangi, Xinying Guanl, Xiaobing Chenm, Xiaomin Yana, Zhaoping Zhanga, Jiacheng Liun, Rui Huanga,
Autor para correspondencia
doctor_hr@126.com

Corresponding authors.
, Chuanwu Zhub,
Autor para correspondencia
zhuchw@126.com

Corresponding authors.
, Chao Wua,
Autor para correspondencia
dr.wu@nju.edu.cn

Corresponding authors.
a Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
b Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, China
c Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
d Department of Infectious Diseases, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
e Department of Critical Medicine, Huai’an No. 4 People's Hospital, Huai’an, China
f Department of Infectious Diseases, Nantong Third People's Hospital, Nantong University, Nantong, China
g Department of Quality Control Office, Huai’an No. 4 People's Hospital, Huai’an, China
h Department of Infectious Diseases, The Third People's Hospital of Yangzhou, Yangzhou, China
i Department of Infectious Diseases, Yancheng Second People's Hospital, Yancheng, China
j Department of Tuberculosis, The Third People's Hospital of Changzhou, Changzhou, China
k Department of Gastroenterology, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, China
l Department of Neurology, The Affiliated Hospital of Kangda College of Nanjing Medical University, The First People's Hospital of Lianyungang, Lianyungang, China
m Department of Emergency, The Affiliated Hospital of Kangda College of Nanjing Medical University, The First People's Hospital of Lianyungang, Lianyungang, China
n Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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Table 1. Demographic and epidemiologic characteristics of COVID-19 patients with and without metabolic syndrome.
Table 2. Clinical characteristics of COVID-19 patients with and without metabolic syndrome.
Table 3. Treatment and prognosis of patients with and without metabolic syndrome.
Table 4. Univariate and multivariate analysis of risk factors for severe coronavirus disease 2019.
Table 5. Laboratory and radiological examinations of COVID-19 patients with Non-MS and MS at follow-up.
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Abstract
Background

Few studies have investigated the impacts of metabolic syndrome (MS) on coronavirus disease 2019 (COVID-19). We described the clinical features and prognosis of confirmed COVID-19 patients with MS during hospitalization and after discharge.

Methods

Two hundred and thirty-three COVID-19 patients from the hospitals in 8 cities of Jiangsu, China were retrospectively included. Clinical characteristics of COVID-19 patients were described and risk factors of severe illness were analyzed by logistic regression analysis.

Results

Forty-five (19.3%) of 233 COVID-19 patients had MS. The median age of COVID-19 patients with MS was significantly higher than non-MS patients (53.0 years vs. 46.0 years, P=0.004). There were no significant differences of clinical symptoms, abnormal chest CT images, and treatment drugs between two groups. More patients with MS had severe illness (33.3% vs. 6.4%, P<0.001) and critical illness (4.4% vs. 0.5%, P=0.037) than non-MS patients. The proportions of respiratory failure and acute respiratory distress syndrome in MS patients were also higher than non-MS patients during hospitalization. Multivariate analysis showed that concurrent MS (odds ratio [OR] 7.668, 95% confidence interval [CI] 3.062–19.201, P<0.001) and lymphopenia (OR 3.315, 95% CI 1.306–8.411, P=0.012) were independent risk factors of severe illness of COVID-19. At a median follow-up of 28 days after discharge, bilateral pneumonia was found in 95.2% of MS patients, while only 54.7% of non-MS patients presented bilateral pneumonia.

Conclusions

19.3% of COVID-19 patients had MS in our study. COVID-19 patients with MS are more likely to develop severe complications and have worse prognosis. More attention should be paid to COVID-19 patients with MS.

Keywords:
Coronavirus disease 2019
Metabolic syndrome
Prognosis
Abbreviations:
COVID-19
SARS-CoV-2
ICU
MS
WHO
ARDS
BMI
TG
TC
FBG
IQR
SARS
Resumen
Antecedentes

Pocos estudios han investigado el impacto del síndrome metabólico (SM) en la enfermedad por coronavirus 2019 (COVID-19). Describimos las características clínicas y el pronóstico de los pacientes con COVID-19 confirmados con SM durante la hospitalización y después del alta.

Métodos

Se incluyó de forma retrospectiva a 233 pacientes con COVID-19 de los hospitales de 8 ciudades de Jiangsu (China). Se describieron sus características clínicas y se analizaron los factores de riesgo de enfermedad grave mediante un análisis de regresión logística.

Resultados

De los 233 pacientes, 45 (19,3%) tenían EM. La mediana de edad de estos pacientes con EM fue significativamente mayor que la de los pacientes sin él (53,0 años frente a 46,0 años; p = 0,004). No hubo diferencias significativas en cuanto a los síntomas clínicos, las imágenes de TC torácica anormales y los fármacos de tratamiento entre los 2 grupos. Hubo más pacientes con EM que tuvieron enfermedades graves (33,3% frente a 6,4%; p < 0,001) y críticas (4,4% frente a 0,5%; p = 0,037) que los pacientes sin EM. Las proporciones de insuficiencia respiratoria y síndrome de dificultad respiratoria aguda en los pacientes con EM también fueron mayores que en los pacientes sin EM durante la hospitalización. El análisis multivariante mostró que la EM concurrente (odds ratio [OR] 7,668; intervalo de confianza [IC] del 95%: 3,062-19,201; p < 0,001) y la linfopenia (OR 3,315; IC del 95%: 1,306-8,411; p = 0,012) eran factores de riesgo independientes de COVID-19 grave. En una mediana de seguimiento de 28 días tras el alta, se encontró neumonía bilateral en el 95,2% de los pacientes con EM, mientras que solo la presentaron el 54,7% de los pacientes sin EM.

Conclusiones

El 19,3% de los pacientes con COVID-19 tenían EM en nuestro estudio. Los pacientes con COVID-19 y EM son más propensos a desarrollar complicaciones graves y tienen peor pronóstico. Se debe prestar más atención a los pacientes con COVID-19 y EM.

Palabras clave:
Enfermedad por coronavirus 2019
Síndrome metabólico
Pronóstico

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