Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARS-RAS study of the Italian Society of Hypertension

BackgroundTheglobalrateof intensivecareunit(ICU)admissionduringtheCOVID-19pandemicvarieswithincountriesandis amongthemainchallengesforhealthcaresystemsworldwide.Con-flictingresultshavebeenreportedabouttheresponseto coronavirusinfectionandCOVID-19outcomesin menandwomen.Understanding predictorsof intensivecareunitadmissionmightbeof helpforfutureplanningandmanagementof thedisease.MethodsandfindingsWedesigneda cross-sectionalobservationalmulticenternationwidesurveyin Italyto under-standgender-relatedclinicalpredictorsof ICUadmissionin patientswithCOVID-19.We analyze informationfrom2378chartsof ItalianpatientscertifiedforCOVID-19admittedin26hospitals.Threehundredninety-fivepatients(16.6%)requiredICUadmissionduetoCOVID19infection,morefrequentlymen(74%),witha higherprevalenceof comorbidities(1,78±0,06vs1,54±0,03p<0.05).In multivariableregressionmodelmainpredictorsofadmissionto ICUaremalegender(OR1,7495%CI1,36–2,22p<0.0001)andpresenceofobesity(OR2,8895%CI2,03–4,07p<0.0001),chronickidneydisease(OR:1,588;95%,1,036–2,434p<0,05)andhypertension(OR:1,314;95%1,039–1,662;p<0,05).In genderspecificanalysis,obesity,chronickidneydiseaseandhypertensionareassociatedwithhigherrateof admissionto ICUamongmen,whereasin women,obesity(OR:2,564;95%CI1,336–4.920p<0.0001)andheartfailure(OR:1,77595%CI:1,030–3,057)areassoci-atedwithhigherrateof ICUadmission.ConclusionsOurstudydemonstratesthatgenderis theprimarydeterminantof thedisease’sseverityamongCOVID-19.Obesityis theconditionmoreoftenobservedamongthoseadmittedtoICUwithinbothgenders.TrialregistrationClinicaltrials.gov:NCT04331574.