Key result
Cardiometabolic risk factors, particularly diabetes mellitus and obesity, are associated with heightened severity and increased morbimortality in patients infected with COVID-19.
Why the study?
Cardiometabolic risk factors appear associated with heightened severity and increased morbimortality in COVID-19, motivating a summary of the latest evidence on adverse cardiac metabolic profiles.
Do adverse cardiometabolic risk factors increase the severity and mortality of COVID-19 infection?
Do adverse cardiometabolic risk factors increase the severity and mortality of COVID-19 infection?
Cardiometabolic risk factors such as obesity, metabolic syndrome, and diabetes significantly increase the risk of severe disease and mortality in COVID-19 patients, likely due to a chronic proinflammatory state exacerbating viral-induced immune dysregulation.
May inform risk stratification in COVID-19; extends observational data but leaves causal mechanisms and interventions open.
BACKGROUND: Cardiovascular (CV) risk factors, particularly cardiometabolic, seem to be associated with heightened severity and increased morbimortality in patients infected with the novel Coronavirus disease-2019 (COVID-19). METHODS: A thorough scoping review was conducted to elucidate and summarize the latest evidence for the effects of adverse cardiac metabolic profiles on the severity, morbidity, and prognosis of COVID-19 infection. RESULTS: The pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is complex, being characterized by viral-induced immune dysregulation and hypercytokinemia, particularly in patients with critical disease, evolving with profound endothelial dysfunction, systemic inflammation, and prothrombotic state. Moreover, cardiovascular comorbidities such as diabetes are the most prevalent amongst individuals requiring hospitalization, raising concerns towards the clinical evolution and prognosis of these patients. The chronic proinflammatory state observed in patients with cardiovascular risk factors may contribute to the immune dysregulation mediated by SARS-CoV-2, favoring more adverse clinical outcomes and increased severity. Cardiometabolism is defined as a combination of interrelated risk factors and metabolic dysfunctions such as dyslipidemia, insulin resistance, impaired glucose tolerance, and central adiposity, which increase the likelihood of vascular events, being imperative to specifically analyze its clinical association with COVID-19 outcomes. CONCLUSION: DM and obesity appears to be important risk factors for severe COVID-19. The chronic proinflammatory state observed in patients with excess visceral adipose tissue (VAT) possibly augments COVID-19 immune hyperactivity leading to more adverse clinical outcomes in these patients.
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Muxfeldt et al. (2022) conducted a review in COVID-19. Cardiometabolic risk factors (obesity, diabetes, metabolic syndrome, dyslipidemia) vs. Absence of cardiometabolic risk factors was evaluated on COVID-19 severity, morbidity, and prognosis. Cardiometabolic risk factors, particularly diabetes mellitus and obesity, are associated with heightened severity and increased morbimortality in patients infected with COVID-19.
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