Predictive Biomarkers of COVID-19 Severity in SARS-CoV-2 Infected Patients with Obesity and Metabolic Syndrome

Abstract

In SARS-CoV-2-infected patients, obesity, hypertension, and diabetes are dangerous factors that may result in death. Priority in detection and specific therapies for these patients are necessary. We wanted to investigate the impact of obesity and metabolic syndrome (MS) on the clinical course of COVID-19 and whether prognostic biomarkers described are useful to predict the evolution of COVID-19 in patients with obesity or MS. This prospective cohort study included 303 patients hospitalized for COVID-19. Participants were first classified according to the presence of obesity; then, they were classified according to the presence of MS. Clinical, radiologic, and analytical parameters were collected. We reported that patients with obesity presented moderate COVID-19 symptoms and pneumonia, bilateral pulmonary infiltrates, and needed tocilizumab more frequently. Meanwhile, patients with MS presented severe pneumonia and respiratory failure more frequently, they have a higher mortality rate, and they also showed higher creatinine and troponin levels. The main findings of this study are that IL-6 is a potential predictor of COVID-19 severity in patients with obesity, while troponin and LDH can be used as predictive biomarkers of COVID-19 severity in MS patients. Therefore, treatment for COVID-19 in patients with obesity or MS should probably be intensified and personalized.

Are lipid ratios and triglyceride-glucose index associated with critical care outcomes in COVID-19 patients?

“…Accumulating evidence indicates that loss of metabolic health is a key risk factor for the severity of COVID-19 [ 9 , 29 ]. It is well characterized that IR and related metabolic disorders especially metabolic syndrome, CVD, and T2DM are correlated with poor prognosis of COVID-19 [ 30 , 31 ]. In accordance with previous studies [ 32 , 33 ], the current study also demonstrated that the presence of comorbidities such as T2DM, cancer, asthma, chronic kidney disease, neurological diseases, and CVD are related to more severe illness in COVID-19 patients.…”

Resistin and IL-15 as Predictors of Invasive Mechanical Ventilation in COVID-19 Pneumonia Irrespective of the Presence of Obesity and Metabolic Syndrome

“…The potential molecular mechanisms whereby obesity contributes to the pathogenesis of COVID-19, in addition to the obesity-related deregulated immune response, are chronic inflammation, endothelial imbalance, metabolic dysfunction and its associated comorbidities, and dysfunctional mesenchymal stem cells/adipose-derived mesenchymal stem cells [ 11 ]. In addition to obesity, the components of metabolic syndrome (MS) also seem to be associated with severe COVID-19 [ 12 , 13 , 14 , 15 ]. It has been suggested that enhanced angiotensin converting enzyme 2 (ACE2) expression, pre-existing endothelial dysfunction and a procoagulant state induced by adipocytokine deregulation in MS may play a crucial role in the development of severe COVID-19 [ 16 ].…”

Metabolic syndrome correlates with significantly adverse disease outcomes in COVID-19 patients during the second wave of pandemic

“…As the corona virus continues to develop, (1,2) the more severe form of diseases leading to death, have supposed to occur more frequently in older patients and those who have some underlying comorbidities. Among several comorbidities, Diabetes Mellitus (DM) and Hypertension both have been reported to be present in a large number of COVID-19 patients across the world (3)(4)(5)(6)(7). Among many other comorbidities, the older patients with Cardiovascular Diseases (CVD) were observed to be highly represented, suggesting that there was a higher risk for worse outcomes of COVID-19 on this population (8) (9).…”