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In this retrospective review of 1190 patients hospitalized with COVID-19, univariate analysis found higher rates of acute kidney injury (5.5% vs 2.9%; P = .026), acute cardiac injury (9.1% vs 4.3%; P = .001), and mortality (15.7% vs 10.3%; P = 0.005) in men compared with women, although multivariable Cox regression analysis did not confirm a significant difference in in-hospital mortality. Based on more favorable, age-matched inflammatory and organ function profiles in women, including post-menopausal women, the authors posit that hormonal differences may not be the only explanation for sex-based differences in COVID-19 outcomes.
This study adds to a growing body of literature defining potential sex-based differences in outcomes from COVID-19 infection. While the retrospective nature of the study and notable demographic differences between the male and female populations (such as significantly higher rates of hypertension and smoking among men) limit the application of these results, the authors nonetheless offer analysis of a robust amount of data which do not support a significant mortality difference.
– Emmett A. Kistler, MD
This abstract is available on the publisher's site.
The outbreak of COVID-19 caused by SARS-CoV-2 has been a pandemic. The objective of our study was to explore the association between sex and clinical outcomes in patients with COVID-19.
Detailed clinical data including clinical characteristics, laboratory tests, imaging features and treatments of 1190 cases of adult patients with confirmed COVID-19 were retrospectively analyzed. Associations between sex and clinical outcomes were identified by multivariable Cox regression analysis.
There were 635 (53.4%) male and 555 (46.6%) female patients in this study. Higher rates of acute kidney injury (5.5% vs. 2.9%, p = 0.026), acute cardiac injury (9.1% vs. 4.3%, p = 0.001), and disseminated intravascular coagulation (2.5% vs. 0.7%, P = 0.024) were observed in males. Compared with female patients, male patients with COVID-19 had a higher inhospital mortality rate (15.7% vs. 10.3%, p = 0.005). However, Cox regression analysis showed that sex did not influence inhospital mortality of COVID-19 patients.
Male sex was associated with a worse prognosis of COVID-19, but it seems not to be an independent prognostic factor.