COVID-19 – Who is at the greatest risk?

MARKET PLACE: HUMAN RESOURCE WATCH — Metabolic syndrome can put you at higher risk of the severe form of COVID-19. Fortunately, there are ways to avoid becoming a statistic

We have all heard repeatedly since the start of this year that 2020 has changed the way we think about living, possibly indefinitely. Until we have an effective and safe vaccine, or else 70% of the community have been exposed in some way to the coronavirus and developed natural immunity, we will have to continue to live with some restrictions placed on our day-to-day activities.

Everyone is well aware that those at the greatest risk are the sick, elderly, and most vulnerable community members. However, evidence has emerged since this pandemic has gripped the world that other specific groups are also at risk of developing the more severe versions of COVID-19 and are at greater risk for death.

A recent article published in Diabetes Care examined the link between metabolic syndrome and COVID-19. The researchers from New Orleans assessed the outcomes for 287 patients admitted with COVID-19. The groups were divided into those with metabolic syndrome and those without. When comparing the two groups, those with metabolic syndrome (66% of the patients) had a higher chance of being admitted to intensive care (56% versus 24%), greater odds of being placed on a ventilator (48% versus 18%), were more likely to develop the severe respiratory disease (37% versus 11%), and had more probability of death (26% versus 10%). The study concluded that any individual with metabolic syndrome should take stringent precautions to avoid developing COVID-19.

Another study from the University of Glasgow, with just under 429,000 adults aged between 37 to 73, found those with multiple comorbid conditions of metabolic syndrome were at a greater risk of developing COVID-19 and at a higher risk for the more severe complications.

What is a metabolic syndrome?

A metabolic syndrome is a group of five conditions that can lead to heart disease, diabetes and stroke, and put you at higher risk of the severe form of COVID-19. Metabolic syndrome is diagnosed when someone has at least three of these risk factors: high blood glucose (sugar), low levels of HDL or the so-called “good” cholesterol in the blood, high levels of triglycerides in the blood, large waist circumference, or “apple-shaped” body, and high blood pressure.

The root cause of metabolic syndrome is insulin resistance. Insulin is a hormone made in your pancreas in response to glucose absorbed from the intestinal tract into the bloodstream. Insulin causes cells throughout your body to absorb the sugar and use it for energy. Insulin resistance is a condition when cells of the body don’t respond to the hormone insulin. It means that glucose is more likely left in the blood, leading to high blood sugar levels and accumulation of belly fat.

This insulin resistance is partially genetic. The gene is, in fact, the most common genetic abnormality in the world. The insulin resistance gene occurs in 30% of Caucasians, 50% of Asians, and close to 100% of people with darker skin. This gene evolved thousands of years ago because it is a survival advantage if you are a hunter-gatherer but it is a distinct survival disadvantage in the modern world.

As a hunter-gatherer, the gene allows you to store some degree of belly fat when you have an acute kill and consume the beast immediately, as there was no prehistoric refrigerator. You would then live off this belly fat with minimal food for a few days until the next kill. But, bring in the modern world where we have breakfast, lunch, and dinner and sit on our backsides all day, and this stored belly fat becomes progressive and triggers the chronic inflammatory process that drives all of the clinical issues seen with the metabolic syndrome.

Therefore, those born with the insulin-resistant gene find it very easy to develop metabolic syndrome, put on weight around the belly, sustain chronic inflammation and develop diabetes, hypertension, and specific cholesterol abnormalities. There is also an association with metabolic syndrome and increased cardiovascular disease, cancer, fatty liver, gout, and, apparently, COVID-19.

Although insulin resistance is a genetic disorder, poor lifestyle habits are the major factors that take this common gene and turn it into metabolic syndrome, where all the problems begin. This is definitely an example of your “genes loading the gun but your environment pulling the trigger.”

Now, what can you do to minimise the expression of the insulin resistance gene or even reverse metabolic syndrome? Insulin resistance develops when you indulge in a high-calorie or high-sugar diet, lead a sedentary lifestyle, put on excess weight, and live with chronic stress. So, the logical way to reverse insulin resistance is to turn around the unhealthy lifestyle – switching to a low-carbohydrate, low sugar, high-fibre diet such as a big bowl of fresh leafy greens topped with flaxseed and avocado puree, and stick to daily cardio exercises.

But not everyone will succeed easily with these lifestyles change strategies. Tackling the chronic inflammation process that underlies metabolic abnormality is inevitably even trickier, but it is possible if you have the right tactics. Some supplements and natural therapies such as intravenous vitamin C, EGCG from green tea, curcumin, coenzyme Q10, NAD, and vitamin D and can help reverse insulin resistance. If you or your family member have a history of diabetes, stroke, heart disease or have concerns in regards to metabolic syndrome, you might benefit from these treatments mentioned.

The science behind the treatments

In some cases, certain treatments may use some of the supplements listed above. However, all patients are different, and this is why personalising a patient’s treatment plan through evidence-based practice is extremely important.

In addition, everyone can benefit from a well-planned preventative care program and diagnostic screening that focuses on hidden inflammation. It can help prevent metabolic syndrome plus reduce susceptibility to COVID-19.


Authors: Miskawaan Health Group (MHG). For further information please visit us online at Miskawaan.com or contact us via: contact@miskawaanhealth.com or call (0)2086 8888.

Series Editor: Christopher F. Bruton, Executive Director, Dataconsult Ltd, chris@dataconsult.co.th. Dataconsult’s Thailand Regional Forum provides seminars and extensive documentation to update business on future trends in Thailand and in the Mekong Region.