Table 4.
Association of Cardiometabolic Risk Factors With Degrees of COVID-19 Severity
| General Population (% With Risk Factor) | COVID-19 Positive Total (% With Risk Factor) | COVID-19 Positive Not Severe (% With Risk Factor) | COVID-19 Positive Severe (% With Risk Factor) |
||
|---|---|---|---|---|---|
| Hospitalization | Intensive Care Unit | Mortality | |||
| Obesity∗ | |||||
| China (6.2) | ND | ND | 22 | 25.5–27.0 | 88.2 |
| France (21.6–25.8) | ND | ND | ND | 47.6 | ND |
| United States (34.0–42.4) | ND | 14.4 | 14–53.7 | 19.0–45.7† | ND |
| Diabetes | |||||
| China (9.2–10.9) | 2–22 | 4.5–11 | 7.4–19 | 13.8–34.6 | 7.3–31‡ |
| Italy (5-9) | 33.9–35.5 | ND | ND | 17 | 33.9–35.5 |
| Spain (6.9) | ND | ND | ND | ND | 12 |
| United States (9.8-10.8) | 5.4–10.9 | 5.3–24.0 | 15.0–37.8 | 58 | ND |
| Dyslipidemia | |||||
| United States (12.0) | ND | 10.5 | 25.9 | 26.6 | ND |
| Hypertension | |||||
| China (15.0–44.7) | 9.5–34 | ND | 23.7–40.8 | 58 | 37.6 |
| Italy (30) | ND | ND | ND | ND | 73.8 |
| United States (32.4–44.1) | ND | 11.5 | 37.1–63.0 | 39.5–66.9 | 73.5 |
| CVD | |||||
| China (43) | 1.6–40.0 | ND | 15.7 | 9.6–25.0 | 9.4–11.8 |
| Italy (36) | 36.0–42.5 | ND | ND | ND | 24.5–30.1 |
| United States (30–37.4) | ND | 16.3 | 27.8–44.6 | 30.6–47.1 | 45.6 |
Percentage ranges correspond to the proportion of patients in a country’s general population and at varying levels of COVID-19 severity (column), with a particular cardiometabolic risk factor (row). These percentages are synthesized based on existing published data covering a wide range of surveillance dates, denominators, definitions, and populations, limiting the validity of comparisons and representing research gaps. However, the pattern of increased proportions of these cardiometabolic risk factors with COVID-19 severity compared with the respective general population support a COVID-Related Cardiometabolic Syndrome (figures with increased proportions in bold). See references: China (9,32, 33, 34,37,40,88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98); France (19); Italy (8,99,100); Total (4,31,101, 102, 103, 104); United States (15,20,29,38,47,59,61,105, 106, 107, 108, 109, 110, 111).
COVID-19 = coronavirus disease 2019; CVD = cardiovascular disease; ND = no data (represents epidemiological research gap).
Obesity defined by body mass index >30 kg/m2.
Increased risk for intensive care unit with increased BMI >35 kg/m2 with age <60 years (20).
In largest retrospective study to date in China (n = 72,314), only 0.9% of mortality without any comorbidities, compared with 7.3% with diabetes (66).