ABSTRACT
Background: Metabolic syndrome (MS) has been suggested related to severity of coronavirus disease 2019 (COVID-19). We aimed to identify the association between the presence of MetS and mortality among COVID-19 patients. Methods: We analyzed 3876 adults, confirmed with COVID-19 from January to June, 2020, based on the Korean National Health Insurance Service-COVID-19 data. Participants underwent a health examination provided by the NHIS between 2015 and 2017. The hazard ratios (HRs) of the mortality in COVID-19 patients according to MS were calculated by a multivariable Cox proportional hazards regression analysis. Results: During a follow-up, 3.1% (n = 120) died. The mortality rate was 3.8-fold higher in individuals with MS compared to those without it. The presence of MS was significantly associated with increased risks of mortality in COVID-19 patients even after adjusting for all confounding variables (HR: 1.68, 95% confidence interval [CI]: 1.142.47 in model 3). Of MS components, low high-density lipoprotein cholesterol was prominently associated with a greater mortality risk (HR: 1.63, 95% CI: 1.12-2.37 in model 3). The HRs of mortality increased in individuals with more numbers of MS components (p for trend <0.009 in model 3). Conclusions: The presence of MS and greater number of MS components were associated with increased mortality risk among COVID-19 patients.