Understanding the correlation between metabolic syndrome and COVID-19 may be crucial to improved treatment and outcomes.
The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a global crisis affecting millions of people with more than 40 million confirmed cases worldwide and over a million COVID-19 related deaths. Particularly, the elderly population or those with pre-existing medical conditions, such as diabetes or cardiovascular diseases, are more vulnerable to the infection and its consequences.
While many patients go on to recover from COVID-19, some people may have damage to their lungs and other organs, including the heart, kidney and gastrointestinal tract, among others, as a result of the virus.
Researchers have placed increased attention on the crosstalk between metabolic syndrome (a cluster of metabolic disorders that may include high blood pressure, diabetes, high cholesterol or abdominal obesity, that increases the risk of future cardiovascular disease) and COVID-19.
Researchers are focusing efforts on recognition, prevention and treatment of individuals who may be more susceptible to the more severe and damaging effects of COVID-19, such as those with metabolic syndrome.
In new research published in BIO Integration, scientists from China reviewed and summarized the current knowledge known about metabolic syndrome and COVID-19. Firstly, the virus causing COVID-19, SARS-CoV-2, binds to ACE2 receptors which are found in various organs including the lungs, kidney, heart, liver, brain and intestinal tract.
It is through this ACE2 receptor binding mechanism that the virus gains cell access to cause infection. Since these ACE2 receptors are not only found on the lungs, there is growing evidence that organ damage may have potentially been caused by SARS-CoV-2, thus highlighting the link between metabolic syndrome and COVID-19.
The trigger of a large inflammatory response by the immune system (a “cytokine storm”) to the COVID-19 infection may also play a role between metabolic syndrome and COVID-19.
A pattern of increased levels of inflammatory molecules was found among severe cases of COVID-19 patients. The eventual death of SARS-CoV-2 infected cells leads to the increased production of inflammatory cells and molecules in the surrounding area that ultimately causes dysregulation of the immune system’s response, continued cell damage, and worsening progression of the infection itself.
The interaction between metabolic syndrome and COVID-19 comes down to three main factors: dysfunction of ACE2 receptors, dysregulated immune response (particularly increased inflammation), and abnormal blood coagulation (or clotting).
Current research to date shows evidence of a much higher risk of severe COVID-19 illness, longer hospital stays, or even death in COVID-19 patients who also have diabetes, high blood pressure, obesity, or other cardiovascular diseases.
Understanding the interplay between metabolic syndrome and COVID-19 is important in discovering how current drugs used to treat metabolic conditions may be potentially useful to improve treatment outcomes and prognosis of COVID-19 patients with pre-existing metabolic diseases.
Ultimately, however, the prevention and treatment of COVID-19 and of metabolic diseases themselves are key to reducing death rates and improving clinical outcomes.
Written by Maggie Leung, PharmD.
Guo, Z., Jiang, S., Li, Z., & Chen, S. (2020). Metabolic Syndrome “Interacts” With COVID-19. BIO Integration. doi:10.15212/bioi-2020-0035
Image by Aneta Esz from Pixabay