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. 2021 Feb 5;12(1):20.
doi: 10.1186/s13293-021-00359-2.

Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans

Yilin Yoshida  1   2 , Scott A Gillet  3 , Margo I Brown  3 , Yuanhao Zu  4 , Sarah M Wilson  1   2 , Sabreen J Ahmed  1   2 , Saritha Tirumalasetty  1   2 , Dragana Lovre  1   2 , Marie Krousel-Wood  3   5 , Joshua L Denson  6 , Franck Mauvais-Jarvis  7   8
Affiliations

Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans

Yilin Yoshida et al. Biol Sex Differ. .

Abstract

Objectives: Determine if sex differences exist in clinical characteristics and outcomes of adults hospitalized for coronavirus disease 2019 (COVID-19) in a US healthcare system.

Design: Case series study.

Setting and participants: Sequentially hospitalized adults admitted for COVID-19 at two tertiary care academic hospitals in New Orleans, LA, between 27 February and 15 July 2020.

Measures and outcomes: Measures included demographics, comorbidities, presenting symptoms, and laboratory results. Outcomes included intensive care unit admission (ICU), invasive mechanical ventilation (IMV), and in-hospital death.

Results: We included 776 patients (median age 60.5 years; 61.4% women, 75% non-Hispanic Black). Rates of ICU, IMV, and death were similar in both sexes. In women versus men, obesity (63.8 vs 41.6%, P < 0.0001), hypertension (77.6 vs 70.1%, P = 0.02), diabetes (38.2 vs 31.8%, P = 0.06), chronic obstructive pulmonary disease (COPD, 22.1 vs 15.1%, P = 0.015), and asthma (14.3 vs 6.9%, P = 0.001) were more prevalent. More women exhibited dyspnea (61.2 vs 53.7%, P = 0.04), fatigue (35.7 vs 28.5%, P = 0.03), and digestive symptoms (39.3 vs 32.8%, P = 0.06) than men. Obesity was associated with IMV at a lower BMI (> 35) in women, but the magnitude of the effect of morbid obesity (BMI ≥ 40) was similar in both sexes. COPD was associated with ICU (adjusted OR (aOR), 2.6; 95%CI, 1.5-4.3) and IMV (aOR, 1.8; 95%CI, 1.2-3.1) in women only. Diabetes (aOR, 2.6; 95%CI, 1.2-2.9), chronic kidney disease (aOR, 2.2; 95%CI, 1.3-5.2), elevated neutrophil-to-lymphocyte ratio (aOR, 2.5; 95%CI, 1.4-4.3), and elevated ferritin (aOR, 3.6; 95%CI, 1.7-7.3) were independent predictors of death in women only. In contrast, elevated D-dimer was an independent predictor of ICU (aOR, 7.3; 95%CI, 2.7-19.5), IMV (aOR, 6.5; 95%CI, 2.1-20.4), and death (aOR, 4.5; 95%CI, 1.2-16.4) in men only.

Conclusions: This study highlights sex disparities in clinical determinants of severe outcomes in COVID-19 patients that may inform management and prevention strategies to ensure gender equity.

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Conflict of interest statement

None of the authors have any conflicts of interests to disclose related to the preparation of this manuscript.

Figures

Fig. 1
Fig. 1
Multivariable analysis of Comorbidities and Outcomes
Fig. 2
Fig. 2
Multivariable analysis of Biomarkers and Outcomes
See this image and copyright information in PMC

References

    1. Mauvais-Jarvis F. Aging, male sex, obesity, and metabolic inflammation create the perfect storm for COVID-19. Diabetes. 2020;69(9):1857–1863. doi: 10.2337/dbi19-0023. - DOI - PMC - PubMed
    1. Peckham H, de Gruijter NM, Raine C, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun. 2020;11(1):6317. doi: 10.1038/s41467-020-19741-6. - DOI - PMC - PubMed
    1. Guan W-J, Ni Z-Y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720. doi: 10.1056/NEJMoa2002032. - DOI - PMC - PubMed
    1. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA. 2020;323(20):2052–2059. doi: 10.1001/jama.2020.6775. - DOI - PMC - PubMed
    1. Mauvais-Jarvis F, Bairey Merz N, Barnes PJ, et al. Sex and gender: modifiers of health, disease, and medicine. Lancet. 2020;396(10250):565–582. doi: 10.1016/S0140-6736(20)31561-0. - DOI - PMC - PubMed

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