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QUALITY OF LIFE OF PATIENTS WITH METABOLIC
SYNDROME FOLLOWING COVID-19
U.Z. Mi zae a1, D.T. Mukhammedamino a2, D.R. Maksudo a3, B.B. Begma o 4
Assis an o he depa men o endoc inology, Tashken S a e Medical Uni e si y 1,2,3,4
h ps://doi.o g/10.5281/zenodo.17693792
Abs ac . Me abolic synd ome (MS) e e s o a clus e o in e ela ed ca dio ascula isk
ac o s, including abdominal obesi y, hype ension, impai ed glycemia, and dyslipidemia. I is
es ima ed ha be ween 20 and 30% o he adul popula ion in mos coun ies a e a ec ed by MS
[Fa man a ma K., 2020]. Howe e , he p e alence o MS a ies signi ican ly depending on
geog aphical egion, le el o de elopmen , and diagnos ic c i e ia.
Keywo ds: heal hca e in as uc u e, ele a ed isk, me abolic al e a ions, mild symp oms.
In oduc ion
Acco ding o Wo ld Heal h O ganiza ion (WHO) da a, as o 2022, 2.5 billion adul s aged
18 and olde we e o e weigh , o which 890 million we e classi ied as obese [Ling ay I., 2024].
The p e alence o MS di e s subs an ially ac oss egions, e lec ing dispa i ies in socioeconomic
ac o s and heal hca e in as uc u e. WHO s a is ics show ha in Uzbekis an, he p e alence o
obesi y inc eased om 16.6% o 28.0% be ween 2016 and 2020.
Resea ch conduc ed du ing and a e he COVID-19 pandemic (2019) has indica ed ha
bo h me abolic synd ome and i s indi idual componen s (hype glycemia, hype ension, and
subclinical in lamma ion) a e associa ed wi h an ele a ed isk o se e e COVID-19 ou comes. The
in e sec ion o me abolic synd ome and COVID-19 may se e as a igge o he de elopmen o
pos -COVID endoc ine, ca dio ascula , neu ological, and o he complica ions [S e an N., 2021].
Se e al s udies ha e highligh ed he ad e se e ec s o p olonged qua an ine on he quali y
o li e and psychological heal h o pa ien s eco e ing om COVID-19 [Hao F., 2020; Hsiao C.,
2021; O’Dwye M., 2021; Wu C., 2024].
Objec i e o he S udy. To e alua e he impac o COVID-19 on he quali y o li e o
pa ien s wi h me abolic synd ome.
Ma e ials and Me hods.
This open, p ospec i e s udy included 57 pa icipan s, o which 25 we e pa ien s wi h
me abolic synd ome (MS) who had eco e ed om COVID-19 (G oup 1), 21 pa ien s wi h MS
who had no con ac ed COVID-19 (G oup 2), and 11 heal hy indi iduals aged 58.1±10.6 yea s
(median 61.0 yea s; IQR 49.0–66.5), wi h no me abolic al e a ions and no his o y o co ona i us
in ec ion. The g oups we e compa able in age (G oup 1: 57.0±7.8 yea s; G oup 2: 56.9±8.6 yea s;
p=0.73).
In he s udied coho , he majo i y o pa ien s in G oup 1 had a mild cou se o COVID-19,
wi h 6 (24.0%) expe iencing mild symp oms, 10 (40.0%) ha ing mode a e symp oms, and 4
(16.0%) p esen ing wi h se e e symp oms. Howe e , 5 (20.0%) pa icipan s we e unce ain abou
he se e i y o hei illness, sugges ing ha he in ec ion mos likely had a mild cou se. The mean
ime since discha ge om he in ec ious disease hospi al o COVID-19 ea men was 1.28±0.89
yea s. Inclusion C i e ia: Adul pa ien s (≥18 yea s) who we e hospi alized wi h clinical
mani es a ions o COVID-19, wi h ches CT scan esul s upon admission, and con i med by a PCR
es o SARS-CoV-2. Exclusion C i e ia: Pa ien s who did no p o ide consen o pa icipa ion,
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hospi aliza ions un ela ed o COVID-19 (PCR no con i med), p egnancy, o lac a ion. Among he
pa icipan s, women accoun ed o he majo i y (54.4%).
The quali y o li e o he pa ien s was assessed using he widely ecognized SF-36 (Sho
Fo m Heal h Su ey) ques ionnai e, in acco dance wi h he guidelines o he In e na ional Quali y
o Li e Assessmen (IQOLA) p ojec , de eloped o popula ion-based quali y o li e s udies. The
SF-36 ques ionnai e consis s o 36 ques ions, g ouped in o 8 scales [Wa e J., 2000].
S a is ical da a p ocessing was ca ied ou on a pe sonal compu e using Mic oso Excel
2016 and IBM SPSS S a is ics 23. Co ela ion analysis was ca ied ou using he Pea son
co ela ion coe icien and checking i s eliabili y aking in o accoun he numbe o deg ees o
eedom.
S udy Resul s: A compa a i e analysis was conduc ed using he SF-36 ques ionnai e o
e alua e quali y-o -li e (QoL) indica o s. The s udy included 25 pa ien s wi h me abolic synd ome
(MS) who had expe ienced a co ona i us in ec ion (G oup 1) and 21 pa ien s wi h MS who had
no con ac ed COVID-19 (G oup 2). All pa icipan s ecei ed inpa ien ea men a he
Republican Specialized Scien i ic and P ac ical Medical Cen e o Endoc inology. Among he
pa ien s wi h MS who had expe ienced a co ona i us in ec ion, a signi ican p opo ion epo ed
highe incidences o weakness (odds a io [OR] 4.80; 95% con idence in e al [CI] 1.33–17.3;
p=0.01), sho ness o b ea h (OR 4.71; 95% CI 1.10–20.2; p=0.03), inc eased a igue (OR 6.33;
95% CI 1.20–33.4; p=0.02), memo y impai men (OR 5.34; 95% CI 1.01–28.4; p=0.04), and mood
swings (OR 4.07; 95% CI 1.14–14.6; p=0.03) (Table 1). Table 1.
Key Complain s Repo ed by Pa ien s wi h Me abolic Synd ome.
Indica o s
MS wi h
COVID-19,
n=25
MS wi hou
COVID-19, n=21
Con ol,
n=11
G oup 1
G oup 2
n
%
n
%
n
%
Weakness
15
60,0
5
23,8
1
9,1
Sho ness o b ea h
11
44,0
3
14,3
0
0,0
Palpi a ions
9
36,0
4
19,0
1
9,1
Inc eased a igue
10
40,0
2
9,5
0
0,0
Headaches
11
44,0
5
23,8
2
18,2
Sleep dis u bance
9
36,0
5
23,8
2
18,2
Ches , join , and muscle pain
8
32,0
2
9,5
1
9,1
Dizziness
10
40,0
5
23,8
3
27,3
Memo y impai men
9
36,0
2
9,5
0
0,0
Excessi e swea ing
9
36,0
3
14,3
1
9,1
Mood swings
14
56,0
5
23,8
0
0,0
An e alua ion o QoL indica o s in pa ien s wi h MS, ega dless o hei COVID-19 s a us,
demons a ed a s a is ically signi ican educ ion in QoL when compa ed wi h he con ol g oup
(Table 2).
Fu he analysis o physical heal h domains indica ed ha MS ad e sely a ec s daily
unc ional capaci y, wi h he decline in QoL being mo e p onounced in indi iduals who had
con ac ed COVID-19.
Speci ically, physical unc ioning sco es we e educed by 25.2% in G oup 1 and by 18.2%
in G oup 2. Role unc ioning sco es dec eased by 39.6% in G oup 1 and by 29.7% in G oup 2.
Pain in ensi y was a ed lowe by 25.0% in G oup 1 and by 16.8% in G oup 2. Gene al heal h
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pe cep ion sco es we e diminished by 34.9% in G oup 1 and by 28.5% in G oup 2, while he
physical heal h componen sco es we e educed by 31.1% in G oup 1 and by 23.3% in G oup 2
compa ed o he con ol g oup (Figu e 1). Table 2.
Quali y-o -Li e Sco es in Physical and Men al Heal h Domains o Pa ien s wi h Me abolic
Synd ome (in Poin s).
Indica o s
MS wi h COVID-
19,
n=25
MS wi hou
COVID-19, n=21
Con ol,
n=11
G oup 1
G oup 2
Physical Func iong (PF)
58,2±8,4*
63,5±8,5*
77,8±8,3
Role Physical (RP)
48,0±6,8*
55,9±9,0*
79,5±10,2
Bodily Pain (BP)
59,5±8,4*
66,0±9,9*
79,3±8,2
Gene al Heal h (GH)
50,5±9,0*
55,5±6,7*
77,6±10,3
Physical heal h To al (PHT)
51,4±3,8*
57,2±4,1*
74,6±5,6
Vi ali y (VT)
60,8±8,4*
50,6±7,6*
81,6±11,2
Social Func ioning (SF)
53,8±9,9*
60,8±9,1*
86,3±9,6
Role Emo ional (RE)
58,1±7,0*
63,7±7,3*
82,2±7,7
Men al Heal h (MH)
54,6±8,9*
63,4±8,5*
79,5±11,9
Men al Heal h To al (MHT)
54,0±3,9*
56,6±4,7*
78,3±6,3
No e: - s a is ically signi ican di e ence ela i e o he con ol g oup; # - s a is ically
signi ican di e ence be ween MS pa ien s wi hou COVID-19.
Fig. 1. Quali y-o -Li e Indica o s o he Physical Heal h Componen .
In addi ion, pa ien s wi h MS exhibi ed signi ican impai men s in psychological well-
being. Vi ali y sco es we e educed by 25.5% in G oup 1 and by 38.0% in G oup 2. Social
unc ioning sco es declined by 37.7% in G oup 1 and by 29.5% in G oup 2. Emo ional ole
unc ioning sco es dec eased by 29.3% in G oup 1 and by 22.5% in G oup 2. Men al heal h sco es
we e educed by 31.3% in G oup 1 and by 20.3% in G oup 2, while he men al heal h componen
sco es we e lowe by 31.0% in G oup 1 and by 27.7% in G oup 2 compa ed o he con ol g oup
(Figu e 2).
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Fig.2. Quali y-o -Li e Indica o s o he Men al Heal h Componen .
Pa ien s wi h me abolic synd ome (MS) who eco e ed om COVID-19 expe ienced
signi ican nega i e emo ional impac s on hei quali y o li e, including inc eased heal h- ela ed
anxie y, ele a ed le els o dep ession, and mood dis u bances.
Discussion: The indings o ou s udy indica e a signi ican decline in he quali y o li e
among pa ien s wi h MS who eco e ed om COVID-19 compa ed o hose wi h MS who did no
con ac he in ec ion. An analysis conduc ed using he SF-36 ques ionnai e e ealed mo e
p onounced de e io a ion in bo h he physical and men al heal h componen s wi hin he pos -
COVID-19 coho . Pa ien s wi h MS who had eco e ed om COVID-19 epo ed ma ked
educ ions in physical unc ioning, ole unc ioning ela ed o physical heal h, and o e all i ali y.
These changes a e p ima ily a ibu able o pos -COVID synd ome, which is cha ac e ized by
pe sis en symp oms such as ch onic a igue, muscle weakness, sho ness o b ea h, educed
exe cise ole ance, myalgia, join pain, and exace ba ion o me abolic dis u bances associa ed wi h
MS. These al e a ions a e likely linked o sys emic in lamma ion, endo helial dys unc ion, and
wo sening me abolic s a us, esul ing om bo h SARS-CoV-2 in ec ion and he p e-exis ing
me abolic condi ion in MS pa ien s.
P e ious s udies [Hussain A., 2020; Li B., 2020] ha e co obo a ed ha pa ien s wi h
obesi y and hype insulinemia a e mo e suscep ible o se e e mani es a ions o COVID-19 and ace
a highe isk o de eloping long- e m sequelae, including a signi ican decline in physical heal h.
The mos p onounced impai men s in ou coho we e obse ed in emo ional well-being, i ali y,
and social unc ioning. Pa ien s eco e ing om COVID-19 exhibi ed no able psycho-emo ional
dis u bances, including heigh ened anxie y and dep ession, a ibu ed o illness- ela ed s ess and
heal h conce ns. Addi ional symp oms included sleep dis u bances, mood dys egula ion, and
emo ional luc ua ions.
These indings align wi h exis ing li e a u e, which emphasizes ha indi iduals eco e ing
om COVID-19 equen ly encoun e men al heal h challenges, o en exace ba ed by ch onic
in lamma ion and ho monal imbalances [Zhou Y., 2021]. The p esence o MS, cha ac e ized by
insulin esis ance and hype insulinemia, u he p edisposes indi iduals o dep essi e s a es and
cogni i e impai men s. A compa ison wi h MS pa ien s who did no con ac COVID-19 e ealed
ha he la e g oup exhibi ed ela i ely s able quali y o li e. These indings suppo he hypo hesis
ha COVID-19 se es as an addi ional s esso , in ensi ying p e-exis ing heal h issues in MS
pa ien s [Ghoneim S., 2020]. Impo an ly, e en among MS pa ien s who had no expe ienced
COVID-19, he quali y o li e was lowe han ha o he con ol g oup, unde sco ing he inhe en
nega i e impac o MS on physical and men al heal h.
Implica ions o Clinical P ac ice
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These indings emphasize he need o indi idualized, mul idisciplina y ehabili a ion
p og ams o MS pa ien s eco e ing om COVID-19. Key componen s o such p og ams should
include:
1. Physical ehabili a ion o es o e exe cise ole ance and acili a e weigh managemen .
2. Me abolic managemen aimed a glycemic con ol and he ea men o hype lipidemia
and hype ension.
3. Psychological in e en ions o enhance emo ional well-being, alle ia e anxie y, and
imp o e social ein eg a ion.
Conclusion. In summa y, he esul s o his s udy con i m ha COVID-19 signi ican ly
exace ba es he decline in quali y o li e among pa ien s wi h MS. This unde sco es he necessi y
o a comp ehensi e, in e disciplina y app oach o he ea men and ehabili a ion o his pa ien
popula ion. Fu he esea ch, in ol ing la ge coho s, is essen ial o elucida e he long- e m
consequences o COVID-19 in indi iduals wi h MS.
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