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Background It has been observed that subjects with comorbidities related to metabolic syndrome (MetS) as hypertension, obesity, cardiovascular disease (CVD), and diabetes mellitus (DM2) show severe cases and a higher mortality by COVID-19. To date, there is little information available on the impact of the interaction between these comorbidities in the risk of death by COVID-19. Aim of the Study To evaluate the impact of the combinations of MetS components in overall survival (OS) and risk of death among COVID-19 patients. Methods Using public data of the Ministry of Health, suspected, and confirmed COVID-19 cases from February 25–June 6, 2020 was analyzed. Mortality odds ratio (OR) was calculated with a univariate analysis (95% CI) and attributable risk. Interactions between components and survival curves were analyzed and a multivariate logistics regression analysis was conducted. Results The analysis included 528,651 cases out of which 202,951 were confirmed for COVID-19. Probabilities of OS among confirmed patients were 0.93, 0.89, 0.87, 0.86, and 0.83 while the OR of multivariate analysis was 1.83 (1.77–1.89), 2.58 (2.48–2.69), 2.83 (2.66–3.01), and 3.36 (2.83–3.99) for zero, one, two, three, and four MetS components, respectively. The combination with the highest risk was DM2 + hypertension at 2.22 (2.15–2.28), and the attributable risk for any component was 9.35% (9.21–9.49). Only the combination obesity + CVD showed no significant interaction. Conclusion The presence of one MetS component doubles the risk of death by COVID-19, which was higher among patients with DM2 + hypertension. Only obesity and CVD do not interact significantly.