Sex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-19
Males have a higher risk for an adverse outcome of COVID-19. The aim of the study was to analyze sex differences in the clinical course with focus on patients who received intensive care. Research was conducted as an observational retrospective cohort study. A group of 23,235 patients from 83 hospit...
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MDPI AG
2021
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oai:doaj.org-article:7ae8dc026f28493f837d3a2bc55907812021-11-11T17:35:19ZSex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-1910.3390/jcm102149542077-0383https://doaj.org/article/7ae8dc026f28493f837d3a2bc55907812021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4954https://doaj.org/toc/2077-0383Males have a higher risk for an adverse outcome of COVID-19. The aim of the study was to analyze sex differences in the clinical course with focus on patients who received intensive care. Research was conducted as an observational retrospective cohort study. A group of 23,235 patients from 83 hospitals with PCR-confirmed infection with SARS-CoV-2 between 4 February 2020 and 22 March 2021 were included. Data on symptoms were retrieved from a separate registry, which served as a routine infection control system. Males accounted for 51.4% of all included patients. Males received more intensive care (ratio OR = 1.61, 95% CI = 1.51–1.71) and mechanical ventilation (invasive or noninvasive, OR = 1.87, 95% CI = 1.73–2.01). A model for the prediction of mortality showed that until the age 60 y, mortality increased with age with no substantial difference between sexes. After 60 y, the risk of death increased more in males than in females. At 90 y, females had a predicted mortality risk of 31%, corresponding to males of 84 y. In the intensive care unit (ICU) cohort, females of 90 y had a mortality risk of 46%, equivalent to males of 72 y. Seventy-five percent of males over 90 died, but only 46% of females of the same age. In conclusion, the sex gap was most evident among the oldest in the ICU. Understanding sex-determined differences in COVID-19 can be useful to facilitate individualized treatments.Irit NachtigallMarzia BonsignorePetra ThürmannSven HohensteinKatarzyna JóźwiakMichael HauptmannSandra EifertJulius DenglerAndreas BollmannHeinrich V. GroesdonkRalf KuhlenAndreas Meier-HellmannMDPI AGarticlesex differencesage dependencyintensive care unitCOVID-19mechanical ventilationMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4954, p 4954 (2021) |
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DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
sex differences age dependency intensive care unit COVID-19 mechanical ventilation Medicine R |
| spellingShingle |
sex differences age dependency intensive care unit COVID-19 mechanical ventilation Medicine R Irit Nachtigall Marzia Bonsignore Petra Thürmann Sven Hohenstein Katarzyna Jóźwiak Michael Hauptmann Sandra Eifert Julius Dengler Andreas Bollmann Heinrich V. Groesdonk Ralf Kuhlen Andreas Meier-Hellmann Sex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-19 |
| description |
Males have a higher risk for an adverse outcome of COVID-19. The aim of the study was to analyze sex differences in the clinical course with focus on patients who received intensive care. Research was conducted as an observational retrospective cohort study. A group of 23,235 patients from 83 hospitals with PCR-confirmed infection with SARS-CoV-2 between 4 February 2020 and 22 March 2021 were included. Data on symptoms were retrieved from a separate registry, which served as a routine infection control system. Males accounted for 51.4% of all included patients. Males received more intensive care (ratio OR = 1.61, 95% CI = 1.51–1.71) and mechanical ventilation (invasive or noninvasive, OR = 1.87, 95% CI = 1.73–2.01). A model for the prediction of mortality showed that until the age 60 y, mortality increased with age with no substantial difference between sexes. After 60 y, the risk of death increased more in males than in females. At 90 y, females had a predicted mortality risk of 31%, corresponding to males of 84 y. In the intensive care unit (ICU) cohort, females of 90 y had a mortality risk of 46%, equivalent to males of 72 y. Seventy-five percent of males over 90 died, but only 46% of females of the same age. In conclusion, the sex gap was most evident among the oldest in the ICU. Understanding sex-determined differences in COVID-19 can be useful to facilitate individualized treatments. |
| format |
article |
| author |
Irit Nachtigall Marzia Bonsignore Petra Thürmann Sven Hohenstein Katarzyna Jóźwiak Michael Hauptmann Sandra Eifert Julius Dengler Andreas Bollmann Heinrich V. Groesdonk Ralf Kuhlen Andreas Meier-Hellmann |
| author_facet |
Irit Nachtigall Marzia Bonsignore Petra Thürmann Sven Hohenstein Katarzyna Jóźwiak Michael Hauptmann Sandra Eifert Julius Dengler Andreas Bollmann Heinrich V. Groesdonk Ralf Kuhlen Andreas Meier-Hellmann |
| author_sort |
Irit Nachtigall |
| title |
Sex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-19 |
| title_short |
Sex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-19 |
| title_full |
Sex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-19 |
| title_fullStr |
Sex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-19 |
| title_full_unstemmed |
Sex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-19 |
| title_sort |
sex differences in clinical course and intensive care unit admission in a national cohort of hospitalized patients with covid-19 |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/7ae8dc026f28493f837d3a2bc5590781 |
| work_keys_str_mv |
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