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Arnalich Fernández FAuthor

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March 12, 2021
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Article

Gender-Based Differences by Age Range in Patients Hospitalized with COVID-19: A Spanish Observational Cohort Study

Publicated to:Journal of Clinical Medicine. 10 (5): - 2021-01-01 10(5), DOI: 10.3390/jcm10050899

Authors: Josa-Laorden C, Crestelo-Vieitez A, García Andreu MDM, Rubio-Rivas M, Sánchez M, Toledo Samaniego N, Arnalich Fernández F, Iguaran Bermudez R, Fonseca Aizpuru EM, Vargas Núñez JA, Pesqueira Fontan PM, Serrano Ballesteros J, Freire Castro SJ, Pestaña Fernández M, Viana García A, Nuñez Rodriguez V, Giner-Galvañ V, Carrasco Sánchez FJ, Hernández Milián A, Cobos-Siles M, Napal Lecumberri JJ, Herrero García V, Pascual Pérez MLR, Millán Núñez-Cortés J, Casas Rojo JM, On Behalf Of The Semi-Covid-Network

Affiliations

Aragon Institute of Health Research, IIS-Aragon, 50009 Zaragoza, Spain. - Author
Department of Clinical Medicine, Faculty of Medicine, Miguel Hernández University, 03202 Elche, Alicante, Spain. - Author
General Internal Medicine Department, San Juan de Alicante University Hospital, 03550 Alicante, Spain. - Author
Internal Medicine Department, 12 de Octubre University Hospital, 28041 Madrid, Spain. - Author
Internal Medicine Department, A Coruña University Hospital, 15006 A Coruña, Spain. - Author
Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, 08901 Barcelona, Spain. - Author
Internal Medicine Department, Cabueñes Hospital, 33394 Gijón, Asturias, Spain. - Author
Internal Medicine Department, Costa del Sol Hospital, 29603 Málaga, Spain. - Author
Internal Medicine Department, Doctor José Molina Orosa Hospital, 25005 Arrecife, Spain. - Author
Internal Medicine Department, Dr. Peset University Hospital, 45017 Valencia, Spain. - Author
Internal Medicine Department, Elda University General Hospital, 03600 Elda, Alicante, Spain. - Author
Internal Medicine Department, Gregorio Marañon University Hospital, 28007 Madrid, Spain. - Author
Internal Medicine Department, Infanta Cristina University Hospital, 28981 Madrid, Spain. - Author
Internal Medicine Department, Juan Ramón Jiménez Hospital, 21005 Huelva, Spain. - Author
Internal Medicine Department, La Paz University Hospital, 28046 Madrid, Spain. - Author
Internal Medicine Department, La Princesa University Hospital, 28006 Madrid, Spain. - Author
Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain. - Author
Internal Medicine Department, Moisès Broggi Hospital, 08970 Sant Joan Despí, Spain. - Author
Internal Medicine Department, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain. - Author
Internal Medicine Department, Río Hortega University Hospital, Regional Health Management of Castilla y Leon (SACYL), 47012 Valladolid, Spain. - Author
Internal Medicine Department, Royo Villanova Hospital, Avenida San Gregorio 30, 50015 Zaragoza, Spain. - Author
Internal Medicine Department, San Carlos Clinical Hospital, 28040 Madrid, Spain. - Author
Internal Medicine Department, Santiago Clinical Hospital, 15706 Santiago de Compostela, Spain. - Author
Internal Medicine Department, Son Llàtzer University Hospital, 07120 Palma de Mallorca, Spain. - Author
NULL - Author
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Abstract

There is some evidence that male gender could have a negative impact on the prognosis and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of the present study was to compare the characteristics of coronavirus disease 2019 (COVID-19) between hospitalized men and women with confirmed SARS-CoV-2 infection. This multicenter, retrospective, observational study is based on the SEMI-COVID-19 Registry. We analyzed the differences between men and women for a wide variety of demographic, clinical, and treatment variables, and the sex distribution of the reported COVID-19 deaths, as well as intensive care unit (ICU) admission by age subgroups. This work analyzed 12,063 patients (56.8% men). The women in our study were older than the men, on average (67.9 vs. 65.7 years; p < 001). Bilateral condensation was more frequent among men than women (31.8% vs. 29.9%; p = 0.007). The men needed non-invasive and invasive mechanical ventilation more frequently (5.6% vs. 3.6%, p < 0.001, and 7.9% vs. 4.8%, p < 0.001, respectively). The most prevalent complication was acute respiratory distress syndrome, with severe cases in 19.9% of men (p < 0.001). In men, intensive care unit admission was more frequent (10% vs. 6.1%; p < 0.001) and the mortality rate was higher (23.1% vs. 18.9%; p < 0.001). Regarding mortality, the differences by gender were statistically significant in the age groups from 55 years to 89 years of age. A multivariate analysis showed that female sex was significantly and independently associated with a lower risk of mortality in our study. Male sex appears to be related to worse progress in COVID-19 patients and is an independent prognostic factor for mortality. In order to fully understand its prognostic impact, other factors associated with sex must be considered.

Keywords

CoronavirusCovid-19Gender differencesSars-cov-2Spain

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Journal of Clinical Medicine due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine (Miscellaneous).

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 5.15, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-16, the following number of citations:

  • WoS: 11
  • Europe PMC: 8

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-16:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 103.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 117 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 76.65.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 48 (Altmetric).
  • The number of mentions in news outlets: 6 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
  • Assignment of a Handle/URN as an identifier within the deposit in the Institutional Repository: https://repositorio.uam.es/handle/10486/698080