Association between cardiometabolic risk factors and COVID-19 susceptibility, severity and mortality: a review
Association between cardiometabolic risk factors and COVID-19 susceptibility, severity and mortality: a review
Erfan Mohammadi-Vajari,1,*Yasaman Sharifi,2Mahbube Ebrahimpur,3Moloud Payab,4Bagher Larijani,5Zhaleh Shadman,6
1. School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. 2. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 3. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 4. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 5. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 6. Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Introduction: The latest pandemic of the coronavirus has affected all components of the human lifestyles and has unfolded the sickness rapidly at some stage in the world. The coronavirus disease of 2019 (COVID-19) has been recognized as 2019-nCOV. This novel virus motives COVID-19 ailment that has comparable signs and symptoms as severe acute respiratory syndrome coronavirus 2 (SARS-COV2). Since April 10, 2021, a total number of 135 Million cases of COVID-19 occurring in at least 170 countries and territories were reported with relatively 3–4% of fatality rate. Although not all factors affecting mortality and severity of COVID-19 disorder have now been identified, studies have shown that the majority of mortality were amongst patients of > 60.Due to the high incidence of cardio metabolic risk factors in the world population and other roles in changing the course of many diseases, in this study, which is a narrative review article [3], we decided to review the role of COVID-19 and recent pandemic in altering these risk factors such as HTN, DM, dyslipidemia and obesity along with the impact of these metabolic comorbidities in the course of COVID-19 disease in infected people.
Methods: In this study, we aimed to review the articles from the beginning of the pandemic on the impression of cardio metabolic risk factors on COVID-19 and the effectiveness of COVID-19 on how to manage these diseases. All the factors studied in this article, including hypertension, diabetes mellitus, dyslipidemia, and obesity exacerbate the course of Covid-19 disease by different mechanisms, and the inflammatory process caused by coronavirus can also create a vicious cycle in controlling these diseases for patients.
Results: Due to the predominance of individuals with cardio metabolic illnesses, in this pandemic, we decided to review articles on the impact of cardio metabolic risk factors on coronavirus disease 2019 and the viability of coronavirus within the course of cardio metabolic diseases. Various studies revealed the association between the severities of COVID- 19 infection in individuals with hypertension besides the higher frequency of this infection in these people. Most of the articles looked into in this paper concurred on continuing treatment with ACEI or ARB (as the foremost common antihypertensive drugs) during this pandemic and after getting COVID-19 disease. Diabetes is another cardio metabolic risk factor that in this article is perceived as one of the factors that exacerbated COVID-19 infection, but autonomously was not a factor in increasing the chance of developing the disease. Dyslipidemia is a viable factor within the occurrence of myocardial infarction as well as stroke, and is known as a cardio metabolic risk factor impacting human wellbeing. Dyslipidemia affects the COVID-19 infection in several ways, including the level of HDL as a prognostic risk factor of COVID-19 disease severity by multiple components which has been clarified in detail before. There’s a controversy over using statins in COVID-19 infected patients but a plenty of research have supported the usage of these drugs in these patients. Obesity is an epidemic of the last century that in conjunction with the coronavirus pandemic can play an important role in changing the course of this infectious disease. The ACE2 expression in adipose tissue is higher than that in the lungs as a major target organ by COVID-19 implying that adipose tissue may be more vulnerable to COVID-19 infection.
Conclusion: In general, due to the high prevalence of cardiometabolic diseases, especially in the population over 60 years old, it seems that these diseases have contributed to the worsening of COVID-19 disease in a recent pandemic, and monitoring these cardiometabolic risk factors can improve the course of COVID-19 infections and could be beneficial generally.