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The impact of metabolic syndrome on COVID-19 outcomes in asthma

Published: May 23, 2024

So far data suggest that people with asthma are not at increased risk of severe coronavirus disease 2019 (COVID-19). However, the vast majority of studies come from a single center or a region, and there is a need for a better understanding of the global impact of COVID-19 on asthma patients. In addition, some studies indicate that patients with certain types of asthma, such as non-allergic and severe asthma, may be at increased risk of severe COVID-19, a finding that could relate to high burden of metabolic comorbidities seen in these patients. Still, if and how metabolic syndrome influences COVID-19 outcomes in asthma remains unknown.

In a recently published study in The Journal of Allergy and Clinical Immunology: In Practice, Vukoja et al. explored the association between asthma and COVID-19 outcomes in an international cohort of 27, 660 hospitalized COVID-19 patients from 164 hospitals across 23 countries. The authors also explored whether metabolic syndrome and its components (obesity, hypertension, diabetes mellitus and hyperlipidemia) modify the observed association.

As compared to patients without chronic lung diseases (controls), patients with asthma were found to be younger, more frequently female and have higher rates of obesity and metabolic syndrome. When compared to controls, patients with asthma were not at greater risk of hospital death, but required more respiratory support including supplemental oxygen, non-invasive and invasive mechanical ventilation. Presence of metabolic syndrome increased the risk of COVID-19 mortality and need for invasive mechanical ventilation in both asthma and controls with similar magnitude of effect. These results suggest that the burden of metabolic comorbidities in hospitalized patients with asthma is high, and that patients with asthma who have poor metabolic health are at increased risk of severe COVID-19. Understanding the impact of metabolic syndrome on COVID-19 outcomes in asthma may help physicians to identify high-risk patients and optimize patient management.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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