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

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

Autores: 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

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Resumen

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.

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