QUALITY OF LIFE OF PATIENTS WITH METABOLIC SYNDROME FOLLOWING COVID-19

SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 29 QUALITY OF LIFE OF PATIENTS WITH METABOLIC SYNDROME FOLLOWING COVID-19 U.Z. Mirzaeva1, D.T. Mukhammedaminova2, D.R. Maksudova3, B.B. Begmatov4 Assistant of the department of endocrinology, Tashkent State Medical University 1,2,3,4 https://doi.org/10.5281/zenodo.17693792 Abstract. Metabolic syndrome (MS) refers to a cluster of interrelated cardiovascular risk factors, including abdominal obesity, hypertension, impaired glycemia, and dyslipidemia. It is estimated that between 20 and 30% of the adult population in most countries are affected by MS [Farmanfarma K., 2020]. However, the prevalence of MS varies significantly depending on geographical region, level of development, and diagnostic criteria. Keywords: healthcare infrastructure, elevated risk, metabolic alterations, mild symptoms. Introduction According to World Health Organization (WHO) data, as of 2022, 2.5 billion adults aged 18 and older were overweight, of which 890 million were classified as obese [Lingvay I., 2024]. The prevalence of MS differs substantially across regions, reflecting disparities in socioeconomic factors and healthcare infrastructure. WHO statistics show that in Uzbekistan, the prevalence of obesity increased from 16.6% to 28.0% between 2016 and 2020. Research conducted during and after the COVID-19 pandemic (2019) has indicated that both metabolic syndrome and its individual components (hyperglycemia, hypertension, and subclinical inflammation) are associated with an elevated risk of severe COVID-19 outcomes. The intersection of metabolic syndrome and COVID-19 may serve as a trigger for the development of post-COVID endocrine, cardiovascular, neurological, and other complications [Stefan N., 2021]. Several studies have highlighted the adverse effects of prolonged quarantine on the quality of life and psychological health of patients recovering from COVID-19 [Hao F., 2020; Hsiao C., 2021; O’Dwyer M., 2021; Wu C., 2024]. Objective of the Study. To evaluate the impact of COVID-19 on the quality of life of patients with metabolic syndrome. Materials and Methods. This open, prospective study included 57 participants, of which 25 were patients with metabolic syndrome (MS) who had recovered from COVID-19 (Group 1), 21 patients with MS who had not contracted COVID-19 (Group 2), and 11 healthy individuals aged 58.1±10.6 years (median 61.0 years; IQR 49.0–66.5), with no metabolic alterations and no history of coronavirus infection. The groups were comparable in age (Group 1: 57.0±7.8 years; Group 2: 56.9±8.6 years; p=0.73). In the studied cohort, the majority of patients in Group 1 had a mild course of COVID-19, with 6 (24.0%) experiencing mild symptoms, 10 (40.0%) having moderate symptoms, and 4 (16.0%) presenting with severe symptoms. However, 5 (20.0%) participants were uncertain about the severity of their illness, suggesting that the infection most likely had a mild course. The mean time since discharge from the infectious disease hospital for COVID-19 treatment was 1.28±0.89 years. Inclusion Criteria: Adult patients (≥18 years) who were hospitalized with clinical manifestations of COVID-19, with chest CT scan results upon admission, and confirmed by a PCR test for SARS-CoV-2. Exclusion Criteria: Patients who did not provide consent for participation, SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 30 hospitalizations unrelated to COVID-19 (PCR not confirmed), pregnancy, or lactation. Among the participants, women accounted for the majority (54.4%). The quality of life of the patients was assessed using the widely recognized SF-36 (Short Form Health Survey) questionnaire, in accordance with the guidelines of the International Quality of Life Assessment (IQOLA) project, developed for population-based quality of life studies. The SF-36 questionnaire consists of 36 questions, grouped into 8 scales [Ware J., 2000]. Statistical data processing was carried out on a personal computer using Microsoft Excel 2016 and IBM SPSS Statistics 23. Correlation analysis was carried out using the Pearson correlation coefficient and checking its reliability taking into account the number of degrees of freedom. Study Results: A comparative analysis was conducted using the SF-36 questionnaire to evaluate quality-of-life (QoL) indicators. The study included 25 patients with metabolic syndrome (MS) who had experienced a coronavirus infection (Group 1) and 21 patients with MS who had not contracted COVID-19 (Group 2). All participants received inpatient treatment at the Republican Specialized Scientific and Practical Medical Center of Endocrinology. Among the patients with MS who had experienced a coronavirus infection, a significant proportion reported higher incidences of weakness (odds ratio [OR] 4.80; 95% confidence interval [CI] 1.33–17.3; p=0.01), shortness of breath (OR 4.71; 95% CI 1.10–20.2; p=0.03), increased fatigue (OR 6.33; 95% CI 1.20–33.4; p=0.02), memory impairment (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 Complaints Reported by Patients with Metabolic Syndrome. Indicators MS with COVID-19, n=25 MS without COVID-19, n=21 Control, n=11 Group 1 Group 2 n % n % n % Weakness 15 60,0 5 23,8 1 9,1 Shortness of breath 11 44,0 3 14,3 0 0,0 Palpitations 9 36,0 4 19,0 1 9,1 Increased fatigue 10 40,0 2 9,5 0 0,0 Headaches 11 44,0 5 23,8 2 18,2 Sleep disturbance 9 36,0 5 23,8 2 18,2 Chest, joint, and muscle pain 8 32,0 2 9,5 1 9,1 Dizziness 10 40,0 5 23,8 3 27,3 Memory impairment 9 36,0 2 9,5 0 0,0 Excessive sweating 9 36,0 3 14,3 1 9,1 Mood swings 14 56,0 5 23,8 0 0,0 An evaluation of QoL indicators in patients with MS, regardless of their COVID-19 status, demonstrated a statistically significant reduction in QoL when compared with the control group (Table 2). Further analysis of physical health domains indicated that MS adversely affects daily functional capacity, with the decline in QoL being more pronounced in individuals who had contracted COVID-19. Specifically, physical functioning scores were reduced by 25.2% in Group 1 and by 18.2% in Group 2. Role functioning scores decreased by 39.6% in Group 1 and by 29.7% in Group 2. Pain intensity was rated lower by 25.0% in Group 1 and by 16.8% in Group 2. General health SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 31 perception scores were diminished by 34.9% in Group 1 and by 28.5% in Group 2, while the physical health component scores were reduced by 31.1% in Group 1 and by 23.3% in Group 2 compared to the control group (Figure 1). Table 2. Quality-of-Life Scores in Physical and Mental Health Domains for Patients with Metabolic Syndrome (in Points). Indicators MS with COVID19, n=25 MS without COVID-19, n=21 Control, n=11 Group 1 Group 2 Physical Functiong (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 General Health (GH) 50,5±9,0* 55,5±6,7* 77,6±10,3 Physical health Total (PHT) 51,4±3,8* 57,2±4,1* 74,6±5,6 Vitality (VT) 60,8±8,4* 50,6±7,6* 81,6±11,2 Social Functioning (SF) 53,8±9,9* 60,8±9,1* 86,3±9,6 Role Emotional (RE) 58,1±7,0* 63,7±7,3* 82,2±7,7 Mental Health (MH) 54,6±8,9* 63,4±8,5* 79,5±11,9 Mental Health Total (MHT) 54,0±3,9* 56,6±4,7* 78,3±6,3 Note: - statistically significant difference relative to the control group; # - statistically significant difference between MS patients without COVID-19. Fig. 1. Quality-of-Life Indicators for the Physical Health Component. In addition, patients with MS exhibited significant impairments in psychological wellbeing. Vitality scores were reduced by 25.5% in Group 1 and by 38.0% in Group 2. Social functioning scores declined by 37.7% in Group 1 and by 29.5% in Group 2. Emotional role functioning scores decreased by 29.3% in Group 1 and by 22.5% in Group 2. Mental health scores were reduced by 31.3% in Group 1 and by 20.3% in Group 2, while the mental health component scores were lower by 31.0% in Group 1 and by 27.7% in Group 2 compared to the control group (Figure 2). SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 32 Fig.2. Quality-of-Life Indicators for the Mental Health Component. Patients with metabolic syndrome (MS) who recovered from COVID-19 experienced significant negative emotional impacts on their quality of life, including increased health-related anxiety, elevated levels of depression, and mood disturbances. Discussion: The findings of our study indicate a significant decline in the quality of life among patients with MS who recovered from COVID-19 compared to those with MS who did not contract the infection. An analysis conducted using the SF-36 questionnaire revealed more pronounced deterioration in both the physical and mental health components within the postCOVID-19 cohort. Patients with MS who had recovered from COVID-19 reported marked reductions in physical functioning, role functioning related to physical health, and overall vitality. These changes are primarily attributable to post-COVID syndrome, which is characterized by persistent symptoms such as chronic fatigue, muscle weakness, shortness of breath, reduced exercise tolerance, myalgia, joint pain, and exacerbation of metabolic disturbances associated with MS. These alterations are likely linked to systemic inflammation, endothelial dysfunction, and worsening metabolic status, resulting from both SARS-CoV-2 infection and the pre-existing metabolic condition in MS patients. Previous studies [Hussain A., 2020; Li B., 2020] have corroborated that patients with obesity and hyperinsulinemia are more susceptible to severe manifestations of COVID-19 and face a higher risk of developing long-term sequelae, including a significant decline in physical health. The most pronounced impairments in our cohort were observed in emotional well-being, vitality, and social functioning. Patients recovering from COVID-19 exhibited notable psycho-emotional disturbances, including heightened anxiety and depression, attributed to illness-related stress and health concerns. Additional symptoms included sleep disturbances, mood dysregulation, and emotional fluctuations. These findings align with existing literature, which emphasizes that individuals recovering from COVID-19 frequently encounter mental health challenges, often exacerbated by chronic inflammation and hormonal imbalances [Zhou Y., 2021]. The presence of MS, characterized by insulin resistance and hyperinsulinemia, further predisposes individuals to depressive states and cognitive impairments. A comparison with MS patients who did not contract COVID-19 revealed that the latter group exhibited relatively stable quality of life. These findings support the hypothesis that COVID-19 serves as an additional stressor, intensifying pre-existing health issues in MS patients [Ghoneim S., 2020]. Importantly, even among MS patients who had not experienced COVID-19, the quality of life was lower than that of the control group, underscoring the inherent negative impact of MS on physical and mental health. Implications for Clinical Practice SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 33 These findings emphasize the need for individualized, multidisciplinary rehabilitation programs for MS patients recovering from COVID-19. Key components of such programs should include: 1. Physical rehabilitation to restore exercise tolerance and facilitate weight management. 2. Metabolic management aimed at glycemic control and the treatment of hyperlipidemia and hypertension. 3. Psychological interventions to enhance emotional well-being, alleviate anxiety, and improve social reintegration. Conclusion. In summary, the results of this study confirm that COVID-19 significantly exacerbates the decline in quality of life among patients with MS. This underscores the necessity for a comprehensive, interdisciplinary approach to the treatment and rehabilitation of this patient population. 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