Article Text

Systematic review of the effect of metabolic syndrome on outcomes due to acute respiratory distress syndrome: a protocol
  1. Gregory Stone1,
  2. Andre Sisk2,
  3. Margo Brown2,
  4. Amy Corder3,
  5. Kevin Tea2,
  6. Yuanhao Zu4,
  7. Jeff Shaffer4,
  8. Rahul Kashyap5,
  9. Nida Qadir6,
  10. Joshua Lee Denson2
  1. 1Department of Internal Medicine, UCLA, Los Angeles, California, USA
  2. 2Section of Pulmonary Diseases, Critical Care, and Environmental Medicine, John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
  3. 3Rudolph Matas Library of the Health Sciences, Tulane University, New Orleans, Louisiana, USA
  4. 4Department of Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
  5. 5Department of Research, WellSpan Health, York, Pennsylvania, USA
  6. 6Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, UCLA, Los Angeles, California, USA
  1. Correspondence to Joshua Lee Denson; Jdenson{at}


Introduction Acute respiratory distress syndrome (ARDS) is a life-threatening condition commonly seen in the intensive care unit. COVID-19 has dramatically increased the incidence of ARDS—with this rise in cases comes the ability to detect predisposing factors perhaps not recognised before, such as metabolic syndrome (MetS) and its associated conditions (hypertension, obesity, dyslipidaemia and type 2 diabetes mellitus). In this systematic review, we seek to describe the complex relationship between MetS, its associated conditions and ARDS (including COVID-19 ARDS).

Methods and analysis A systematic search of PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL and Web of Science will be conducted. The population of interest is adults with ARDS and MetS (as defined according to the study author recognising that MetS definitions vary) or any MetS-associated condition. The control group will be adult patients with ARDS without MetS or any individual MetS-associated condition. We will search studies published in English, with a date restriction from the year 2000 to June 2023 and employ the search phrases ‘metabolic syndrome’, ‘acute respiratory distress syndrome’ and related terms. Search terms including ‘dyslipidaemia’, ‘hypertension’, ‘diabetes mellitus’ and ‘obesity’ will also be utilised. Outcomes of interest will include mortality (in-hospital, ICU, 28-day, 60-day and 90-day), days requiring mechanical ventilation and hospital and/or ICU length of stay. Study bias will be assessed using the NIH Bias Scale.

Ethics and dissemination Ethical approval is not required because this study includes previously published and publicly accessible data. Findings from this review will be disseminated via publication in a peer-reviewed journal.

PROSPERO registration number CRD42023405816.

  • COVID-19
  • Adult intensive & critical care
  • Respiratory Distress Syndrome
  • RESPIRATORY MEDICINE (see Thoracic Medicine)
  • Systematic Review

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  • Contributors GS, AS and MB will search databases and extract and organise data from collected articles. AC will assist with expanding the database search. YZ and JS will perform statistical analysis. GS and KT drafted the manuscript. RK, NQ and JLD provided overarching guidance and mentorship and study direction, formulated the research question and edited manuscript drafts.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.