Comparative Review Analysis Between Metabolic Syndrome and COVID-19

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International Research Journal of Modernization in Engineering Technology and Science

( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:03/Issue:11/November-2021 Impact Factor- 6.752 www.irjmets.com
COMPARATIVE REVIEW ANALYSIS BETWEEN METABOLIC
SYNDROME AND COVID-19
Saptarshi Bhattacharyya*1, Adrita Das*2, Subhra Sulipta Jena*3, Dr. Llalli Smruti Sahu*4,
Dr. Gopal Krishna Purohit*5
*1,2,3,5Heredity Life Science Private Limited, N/448 Jaydev Vihar, Bhubaneswar, Odisha, India.
*4Department Of Microbiology, SCB Medical College, Cuttack, Odisha, India.
ABSTRACT
The considerable episode of the COVID-19 in 2019 from Wuhan, China and it's spreading worldwide has turned
into a question of extraordinary concern. Many research works have been conducted and some vaccines have
been generated for treatment of the novel SARS-CoV-2. Ongoing studies have affirmed the connection between
metabolic syndrome and COVID-19. The investigations demonstrate that the patients experiencing digestion
comorbidities like diabetes, hypertension, dyslipidemia and corpulence are more vulnerable to the results of
Covid disease. Angiotensin-evolving compound (ACE) 2 is the versatile access receptor of SARS-CoV-2.
Likewise, upgraded articulation of the ACE 2, prior endothelial brokenness, vascular brokenness, hazard of
atherothrombotic occasions and adipocytokines dysregulation inciting procoagulant state in metabolic
condition assume a vital part in the advancement of the intense COVID-19 contamination. The historical
backdrop of the patient enduring metabolic comorbidities and late contact with the individual with COVID-19
with viable indications will forestall further spreading of the disease. Due to the comparability of COVID-19
with SARS-CoV-2 and SARS-CoV, the same impacts can be anticipated from COVID-19 over the long haul. Since
there is no huge medication fostered that effectively treats COVID-19, these scientists will support the
distinguishing proof of the powerful medication against every one of the contaminated patients with or without
a background marked by metabolic disorder for their ideal administration. This audit examines the scope of
clinical elements, the conceivable pathophysiologic components and the derivations for the control of metabolic
disorder in COVID-19 contaminated patients. The information dependent on the topographical and ethnic
variety will help to decide the seriousness of COVID-19 disease because of metabolic condition.
Keywords: Metabolic Syndrome, Obesity, CVD, Diabetes, Dyslipidemia, NAFLD, ACE2, SARS-Cov-2.
I. INTRODUCTION
During the course of COVID-19 infection, many patients worldwide have shown comorbidities related to
metabolic syndrome (MS). It is actively present in various countries and continents; thus, MS is considered as
an important risk factor for COVID-19. Adequate investigation of the interplay between MS and COVID-19 is yet
to be performed.
The virus has taken the form of a pandemic due to its high rate of infectivity, killing millions of people
worldwide. The patients with high age and those with comorbidities are the worst victims. The symptoms
range from asymptomatic patients to extreme, fatal respiratory failure [1]. Some risk factors may have their
possible association with the ever evolving nature and severity of the disease. In a USA based survey during
March 2020, among 1482 patients hospitalized with COVID-19 in 14 states, 12% of them had a history of
comorbidities. Of this, 49.7% had hypersensitivity, 48.3% had obesity, 34.6% had chronic liver diseases, 28.3%
had diabetes and 27.8% had cardiovascular diseases[2].
Again, in a Wuhan, China based report, among 191 COVID positive patients with COVID-19, 48% had
comorbidities viz. hypertension (30%), diabetes (19%) and coronary disease (8%) [3]. Also, Brazil had
alarming numbers of COVID cases related to comorbidities (13,868 among 347,398) until June 1, 2020. The
most common comorbidity included heart diseases followed by diabetes, kidney dysfunctions, neurological
disease, pneumopathy, immunosuppression, obesity and asthma in descending order [4]. Thus, naturally,
metabolic syndrome (MS) is considered as a common denominator to these comorbidities, since it is described
as a set of metabolic disorders that include obesity, dyslipidemia, insulin resistance, hypertension etc. which
are risk factors for type 2 diabetes and cardiovascular diseases [5,6].
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II. OBESITY AND COVID-19
The assemblages of fat patients contains high convergences of chemokines, adipokines and favorable to
provocative cytokines, that outcomes in consistent ongoing aggravation, which thusly postpones the safe
reaction joined by diminished enactment of macrophages along the course of the disease. With this, the
invulnerable memory of the hefty people likewise endures debilitation, both cells just as humoral.
Subsequently, the vaccination of these patients incapacitate [9,10].
A New York based investigation led with 3615 COVID positive patients uncovered that 21% of them had
corpulence and 16% of complete had a weight record (BMI) > 35 kg/m2, plainly recommending extreme
heftiness. These patients required thorough consideration in the escalated care unit(ICU) in light of the fact that
they were more disposed to seriousness [11].
As indicated by one more review in New York performed among 4103 COVID positive patients, 48.9% were
hospitalized. Exhaustive investigation has demonstrated that the people with BMI > 40 kg/m2 were inclined to
get hospitalized by 6 fold.[12].
With view to the up-shooting instances of COVID-19 in nations like the U.S.A( 36% fat individuals) [14], and in
Europe(10 to 30% fat people)[15], it can't be disregarded that corpulence represents a major issue w.r.t
COVID-19.
III. DIABETES AND COVID-19
It is found in a review that among the COVID-19 influenced diabetic patients, 21.5% individuals kicked the
bucket; just 3.9% endure [16]. Diabetes is a comorbidity that can generously demolish the SARS-CoV-2
contamination, that may prompt demise of the patient.
It was found in a progression of Wuhan put together meta-examination conveyed with respect to 40,000 COVID
positive patients that 8% of these subjects were diabetic [15]. In the accompanying meta-investigation,
among191 COVID positive patients, 54 kicked the bucket and 31% were diabetic [17]. The demise rate
expanded from 2.3% to 7.3% when examined diabetics patients in a similar gathering [18].
As per a theory, the factor of high quality articulation of angiotensin-changing over chemical 2 (ACE2) is
without a doubt identified with this high proclivity of diabetic patients to COVID19. This relationship is to some
degree comprehended and requests more itemized research[20].
Figure 1: Basic picture of SARS-CoV-2.

IV. CARDIOVASCULAR DISEASE AND COVID-19
Cardiovascular diseases(CVD) and hypertension are the most recognizable comorbidities found among the
COVID influenced patients around the world, making these a strong danger factor for the disease[1,3,16,17,19].
There are a lot of studies accessible in this field, for instance, a review was finished of 99 COVID contaminated
patients; among them 21% had hypertension or coronary illness, 32 patients had extreme pneumonia and 17
people showed some feeling sicknesses [22].

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Information from a Chinese based meta-investigation led among 44,672 COVID positive patients suggested a
death pace of 2.3% for patients with no comorbidities; while the death rate was 6% for patients with
hypertension and was 10.5% for patients with CVD [21]. What's more, those COVID tainted patients who had
CVD as a comorbidity had intense myocardial injury with higher convergence of cardiovascular troponin I
[21,24].
CVD had consistently been an intense reason for passings already also, brought about by inactive way of life and
undesirable food propensities. MS is a contributing variable to the improvement of CVD and under this
pandemic stricken minutes, because of lockdown and all, the stationary way of life of individuals has made a
considerable force.
V. LIVER AND COVID-19
Many examinations have demonstrated the harming impacts of COVID-19 on hepatic tissues. What's more,
pathologies that influence it are considered as hazard factors for serious signs of pneumonia brought about by
the infection [25].
Hepatocytes have ACE2 catalyst on their surface, making it a viable area for SARS-CoV-2 to contaminate [26].
Under the current pandemic, a few examinations have effectively noticed strange groupings of liver capacity
markers. An investigation performed with 202 patients demonstrated that patients with nonalcoholic greasy
liver infection (NAFLD) had a higher danger of COVID-19 movement, and of the 39 patients with reformist
condition, 34 (87%) had NAFLD. Favorable to fiery cytokines which are set free from adipocytes cause
aggravation of hepatocytes. This aggravation gets upgraded because of the presence of SARS-CoV-2 [28].
Expanded degrees of transaminases were found in 20% to 30% of the COVID positive patients, most
prominently in those connected with heftiness and nonalcoholic greasy liver sickness (NAFLD) [28,30]. Further
examination will uncover if the liver harm is essential in provocative response or infection interceded, or
auxiliary i.e intervened by treatment medications and hypoxia brought about by pneumonia. [27,30].
In this way, NAFLD, which is viewed as the hepatic sign of MS can be assigned as a comorbidity [31]. Its far and
wide presence can be approved from the way that 20% to 30% of the Western populace; and 5% to 18% of the
Asiatic populace is vitiated by this with prominent expansion in stout and diabetic patients [32].
More investigations are proceeding to uncover more dependable information and knowledges on the
connection among NAFLD and COVID-19.
Figure 2: The percentage of occurrence of MS risk factors in COVID-19 affected patients in Wuhan Pulmonary
Hospital and Jinyintan Hospital, China.

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VI. DYSLIPIDEMIA AND COVID-19
Dyslipidemia is recognized by raised serum degree of fatty substances and cholesterol for example extremely
low-thickness lipoprotein(VLDL) and low-thickness lipoprotein (LDL) past low serum levels of high-thickness
lipoprotein(HDL). This conditions contributes astoundingly to the improvement of atherosclerosis,
cardiovascular sickness coming about because of constant vascular coercion to oxidative pressure alongside
inflammation.[33,37-39] Studies have sort out that cholesterol can work with the exchange of the infection
joined by ACE2, prescribe the infection. Besides, fat tissue is proposed to work for as a supply particularly for
the infection in COVID-19.With respects to Complications, hyperlipidemia is corresponded with vascular glitch
and increment hazard of atherothrombotic events. The infection can likewise wellspring of direct endothelial
obliteration for intense thrombotic events. The infection can also prompt direct endothelial destruction, as well
as cholesterol may intense as a replication locales for the SARS-COV-2 in the endothelium, expanding hazard for
serious apoplexy. Thus, the presence of heftiness is associated with an expanded danger of disease through the
infection alongside the improvement of the difficulties and basic sickness. Wei et al found diminishing degree of
LDL, HDL and absolute cholesterol in COVID positive patients is relative to the earnestness of the ailment. HDL
and fatty oils were likewise decreased primarily in basic cases. On the difference, measure of C-receptor protein
(CRP) just as IL-6 were amazingly extend in those patients. A single defense for these alterations in COVID 19
patients might be because of liver harm, which cut down LDL biosynthesis. In furthermore aggravation itself
modifies lipid digestion, for the most part IL-6, which lessens cholesterol trade to the liver. In end, it is
proposed that the SARS-COV-2 can modify the sponginess of the endothelium, which makes break of cholesterol
the interstices, which is inside alveolar space, ready to add to exudate arrangement which is found inside the
lungs of Coronavirus patients. Since, a long haul investigation did among patients with a background marked by
SARS-COV infection, it was found that lipid digestion was unusually regulated.[33-35]
Around 68% patients had hyperlipidemia while 44% had cardiovascular framework irregularities alongside
60% had problems with glucose digestion. Difference to individual without contamination these patients
introduced higher measure of unsaturated fats (FFA), lysophosphatidylcholine, lysophosphatidylethanolamine
just as phosphatidylglycerol. In established truth, there is a connection between the viral diseases and
expanded danger for atherosclerosis coming about because of slowly creation of lipoprotein just as fibrinogen,
predisposing the patient to atherothrombotic events.[33,36]. The specific results can be expected for COVID-19
in the long haul brought about by the look like of SARS-COV-2 alongside SARS-COV.[38,40]
VII. FUTURE RESEARCH PROSPECTS
As the preclinical and clinical exercises continue with expanded speed, more information on the physiology and
pathology of the SARS-COV-2 will get uncovered. All things considered, some critical inconsistencies are yet to
be set up. The justification for why cardiometabolic disorder puts a person at a high danger for serious COVID
19 is as yet indistinct. Likewise, the points identified with precipitation of DKA, growing the danger for
myocardial injury, extreme fiery reaction alongside hypercoagulability just as adjustments of insusceptible
framework require further exploration. Moreover, proceeding with concentrates on zeroed in on researching
hereditary determinants of hazard and genuine sickness of COVID-19 will offer extra perception.[41]
VIII. CONCLUSION
The turn of events and forecast of COVID-19 is profoundly interlinked with its danger factor-Metabolic
disorder. The predominance of patients in whom corpulence, diabetes, touchiness or liver harm is found
alongside extreme instances of COVID-19, in different nations, exhibits the significance of the consideration
with this danger bunch, in prophylaxis, checking and treatment.
The by and by assessed drugs request extra examinations to improve the security and adequacy levels because
of the disturbing impacts of mix treatment or the infective impacts of the infection. Fostering an antibody for
vaccination is as yet the best long haul answer for forestalling the future SARS-CoV-2 flare-up. Last but not the
least, individuals of all ages with previous infections, cardiovascular illnesses, heftiness and so forth are
additionally required to increment their precautionary measure levels to turn away or battle off the COVID-19.

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Figure 1: Basic picture of SARS-CoV-2.

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