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 × 103 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.

Sex-related differences in patients with coronavirus disease 2019: results of the Cardio-COVID-Italy multicentre study / C.M. Lombardi, C. Specchia, F. Conforti, M.T.L. Rovere, V. Carubelli, P. Agostoni, S. Carugo, G.B. Danzi, M. Guazzi, A. Mortara, M. Piepoli, I. Porto, G. Sinagra, M. Volterrani, P. Ameri, M. Gnecchi, S. Leonardi, M. Merlo, A. Iorio, A. Bellasi, C. Canale, R. Camporotondo, F. Catagnano, L.A.D. Vecchia, M. Di Pasquale, S. Giovinazzo, G. Maccagni, M. Mapelli, D. Margonato, L. Monzo, V. Nuzzi, C. Oriecuia, L. Pala, G. Peveri, A. Pozzi, G. Provenzale, F. Sarullo, M. Adamo, D. Tomasoni, R.M. Inciardi, M. Senni, M. Metra. - In: JOURNAL OF CARDIOVASCULAR MEDICINE. - ISSN 1558-2027. - 23:(2022), pp. 254-263. [10.2459/JCM.0000000000001261]

Sex-related differences in patients with coronavirus disease 2019: results of the Cardio-COVID-Italy multicentre study

F. Conforti;P. Agostoni;S. Carugo;M. Guazzi;M. Mapelli;G. Peveri;G. Provenzale;
2022

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 × 103 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.
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/899225
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