Relação entre os componentes associados à sindrome metabólica e desfechos clínicos em pacientes com covid-19

Abstract

The metabolic syndrome, considered a dysfunction in the immune system and especially metabolic, is associated with health risk factors and a growing number of new cases every year. Recognized as a pandemic, the metabolic syndrome can induce chronic inflammatory responses and dysfunctions in multiple organs. The pandemic coronavirus 19 disease, responsible for COVID-19, has proven to be one of the most serious and terrifying acute infectious diseases, with numerous deaths and immediate and persistent health complications. The components of the Metabolic Syndrome, as well as COVID-19 are capable of systemically affecting the individual, where by the storm of cytokines, can lead the body to develop complications and evolve into more severe cases. The objective of this study is to identify possible relationships between components of the metabolic syndrome and COVID-19. Also to verify if there is an association between Body Mass Index and clinical evolution of patients, to evaluate the association between risk factors for metabolic syndrome and clinical outcomes, to verify the correlation of the metabolic and inflammatory profile between the groups, through biochemical analysis data, to identify possible analyses between the levels of ghrelin and leptin in the groups. This is a qualitative approach, through retrospective data from medical records, and also another quantitative line, with analyses of metabolic, inflammatory and cellular injury biomarkers in blood samples in controls and COVID-19 subjects. The analysis of samples and medical records has a favorable report from the CEP/UFFS (No. 4.333.214). For all data analyses, initially the normality of the data was verified by the Shapiro-Wilk test, where, the tests for non-parametric used the Kruskal-Wallis test method, Friedman test and Mann-Whitney. GraphPad Prism 8.0.1 statistical program was used. Results were considered significant when significance p< 0.05. Sample size calculation was considered n=76 participants. The risk components for metabolic syndrome accompanied individuals with CODID-19, diseases incident in the sample, diabetes mellitus (58%), followed by dyslipidemias (55%) and systemic arterial hypertension (47%). Also the presence of overweight was observed (51%), where the mean body mass index was 28.18 Kg/m². Overweight and COVID-19 were associated with other characteristics that stood out over other groups in the analysis, such as need for admission to intensive care (75%), use of mechanical ventilation (50%), and death (75%). In the control and COVID-19 groups, we observed changes in the mean value of biochemical and molecular markers, and identified statistical results in increased serum glucose (p=0.0148), elevated triglycerides (p=0.0052), decreased high density lipoprotein (p=0.0258), elevated lactate dehydrogenase (p=0.0009), elevated uric acid (p=0.0020), increased gamma glutamyl transferase (p<0.0001), elevated 8 leptin (p=0.0496), and low mean ghrelin levels (p=0.0311). After evaluating the retrospective data and serum markers, we can consider that the changes in metabolic and inflammatory data found, may relate to the event of COVID-19, however, reveal a possible accentuated vulnerability in patients of the COVID-19 overweight BMI subgroup. These data portend promising care and monitoring pathways in the prognosis and treatment of individuals with preestablished comorbidities during an infection such as COVID-19.