Sex-related differences in patients with coronavirus disease 2019: results of the Cardio-COVID-Italy multicentre study. Issue 4 (31st January 2022)

• Record Type: Journal Article
• Authors: Lombardi, Carlo Mario; Specchia, Claudia; Conforti, Fabio; Rovere, Maria Teresa La; Carubelli, Valentina; Agostoni, Piergiuseppe; Carugo, Stefano; Danzi, Gian Battista; Guazzi, Marco; Mortara, Andrea; Piepoli, Massimo; Porto, Italo; Sinagra, Gianfranco; Volterrani, Maurizio; Ameri, Pietro; Gnecchi, Massimiliano; Leonardi, Sergio; Merlo, Marco; Iorio, Annamaria; Bellasi, Antonio; Canale, Claudia; Camporotondo, Rita; Catagnano, Francesco; Dalla Vecchia, Laura Adelaide; Di Pasquale, Mattia; Giovinazzo, Stefano; Maccagni, Gloria; Mapelli, Massimo; Margonato, Davide; Monzo, Luca; Nuzzi, Vincenzo; Oriecuia, Chiara; Pala, Laura; Peveri, Giulia; Pozzi, Andrea; Provenzale, Giovanni; Sarullo, Filippo; Adamo, Marianna; Tomasoni, Daniela; Inciardi, Riccardo Maria; Senni, Michele; Metra, Marco;
• Is Part Of: Journal of cardiovascular medicine. Volume 23:Issue 4(2022)
• Page Start: 254
• Page End: 263
• Publication Date: 2022-01-31
• Subjects: coronavirus study -- inflammation -- outcome -- sex differences; Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000001261
• Languages: English
• ISSNs: 1558-2027

Abstract

Abstract : Introduction: The role of sex compared to comorbidities and other prognostic variables in patients with coronavirus disease (COVID-19) is unclear. Methods: This is a retrospective observational study on patients with COVID-19 infection, referred to 13 cardiology units. The primary objective was to assess the difference in risk of death between the sexes. The secondary objective was to explore sex-based heterogeneity in the association between demographic, clinical and laboratory variables, and patients' risk of death. Results: Seven hundred and one patients were included: 214 (30.5%) women and 487 (69.5%) men. During a median follow-up of 15 days, deaths occurred in 39 (18.2%) women and 126 (25.9%) men. In a multivariable Cox regression model, men had a nonsignificantly higher risk of death vs. women ( P = 0.07). The risk of death was more than double in men with a low lymphocytes count as compared with men with a high lymphocytes count [overall survival hazard ratio (OS-HR) 2.56, 95% confidence interval (CI) 1.72–3.81]. In contrast, lymphocytes count was not related to death in women ( P = 0.03). Platelets count was associated with better outcome in men (OS-HR for increase of 50 × 10 3 units: 0.88 95% CI 0.78–1.00) but not in women. The strength of association between higher PaO2 /FiO2 ratio and lower risk of death was larger in women (OS-HR for increase of 50 mmHg/%: 0.72, 95% CI 0.59–0.89) vs. men (OS-HR: 0.88, 95% CI 0.80–0.98; P = 0.05). Conclusions: Patients' sex is a relevant variable that should be taken into account when evaluating risk of death from COVID-19. There is a sex-based heterogeneity in the association between baseline variables and patients' risk of death.