Metabolic syndrome and COVID-19

At the end of last year, a new strain of coronavirus emerged in China, which was called SARS-CoV-2. The virus quickly spread throughout the world, reaching pandemic proportions, and is now considered a worldwide public health emergency. In line with this, several studies aimed to postulate and elucidate possible risk factors involved not only in the genesis of coronavirus disease 2019 (COVID-19) but also in the susceptibility and severity of the condition. Among the most reported elements in patients with a more critical clinical scenario and adverse outcomes is metabolic syndrome (MS), a condition consisting of chronic diseases such as obesity, type 2 diabetes mellitus, dyslipidemia, and systemic arterial hypertension. In this light, this work aims to build a descriptive review of the relationship between the factors inherent to MS and COVID-19, in order to better clarify the mechanisms belonging to this association. Resistance to the action of insulin caused by centripetal obesity is permeated by an environment abundant in pro-inflammatory cytokines, which favors the immune imbalance, leading to the modulation of dysfunctional and inefficient responses. Besides, it is important to mention the overlapping of inflammatory secretory patterns of MS with the cytokine storm of COVID-19, leading to a worse prognosis. SARS-CoV-2 and arterial hypertension share pathways through a common enzyme: ACE2, widely expressed in the respiratory epithelium and belonging to the pressure regulation cascade. However, dyslipidemia promotes higher morbidity and mortality through increased cardiovascular risk due to thrombotic events. In short, MS represents a critical element to be considered through association with COVID-19, since it interferes in greater severity and mortality through several factors.