Sex-related differences in mortality, acute kidney injury, and respiratory failure among critically ill patients with COVID-19. Issue 50 (17th December 2021)

• Record Type: Journal Article
• Authors: Toth-Manikowski, Stephanie M.; Caldwell, Jillian; Joo, Min; Chen, Jinsong; Meza, Natalie; Bruinius, Jacob; Gupta, Shruti; Hannan, Mary; Kagalwalla, Mustafa; Madrid, Samantha; Melamed, Michal L.; Pacheco, Esther; Srivastava, Anand; Viamontes, Christopher; Lash, James P.; Leaf, David E.; Ricardo, Ana C.
• Editors: Khan., Abrar Hussain
• Other Names: collaborator.
• Is Part Of: Medicine. Volume 100:Issue 50(2021)
• Page Start: e28302
• Publication Date: 2021-12-17
• Subjects: coronavirus disease 2019 -- mortality -- sex; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000028302
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Supplemental Digital Content is available in the text Abstract : Abstract: Although the number of deaths due to coronavirus disease 2019 (COVID-19) is higher in men than women, prior studies have provided limited sex-stratified clinical data. We evaluated sex-related differences in clinical outcomes among critically ill adults with COVID-19. Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day in-hospital mortality, severe acute kidney injury (AKI requiring kidney replacement therapy), and respiratory failure occurring within 14 days of intensive care unit admission. A total of 4407 patients were included (median age, 62 years; 2793 [63.4%] men; 1159 [26.3%] non-Hispanic White; 1220 [27.7%] non-Hispanic Black; 994 [22.6%] Hispanic). Compared with women, men were younger (median age, 61 vs 64 years, less likely to be non-Hispanic Black (684 [24.5%] vs 536 [33.2%]), and more likely to smoke (877 [31.4%] vs 422 [26.2%]). During median follow-up of 14 days, 1072 men (38.4%) and 553 women (34.3%) died. Severe AKI occurred in 590 men (21.8%), and 239 women (15.5%), while respiratory failure occurred in 2255 men (80.7%) and 1234 women (76.5%). After adjusting for age, race/ethnicity and clinical variables, compared with women, men had a higher risk of death (OR, 1.50, 95% CI, 1.26–1.77), severe AKI (OR, 1.92; 95% CI 1.57–2.36), and respiratory failure (OR, 1.42; 95% CI, 1.11–1.80). In this multicenter cohort of critically ill adults with COVID-19, men were more likely to have adverse outcomes compared with women.