Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Reproductive Medical Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Clin Infect Dis. 2020 Dec 15;71(12):3188-3195. doi: 10.1093/cid/ciaa920.
As the coronavirus disease 2019 (COVID-19) outbreak accelerates worldwide, it is important to evaluate sex-specific clinical characteristics and outcomes, which may affect public health policies.
Patients with COVID-19 admitted to Tongji Hospital between 18 January and 27 March 2020 were evaluated. Clinical features, laboratory data, complications, and outcomes were compared between females and males. Risk factors for mortality in the whole population, females, and males were determined respectively.
There were 1667 (50.38%) females among the 3309 patients. The mortality rate was 5.9% in females but 12.7% in males. Compared with males, more females had no initial symptoms (11.1% vs 8.3%, P = .008). Complications including acute respiratory distress syndrome, acute kidney injury, septic shock, cardiac injury, and coagulation disorder were less common in females; critical illness was also significantly less common in females (31.1% vs 39.4%, P < .0001). Significantly fewer females received antibiotic treatment (P = .001), antiviral therapy (P = .025), glucocorticoids treatment (P < .0001), mechanical ventilation (P < .0001), and had intensive care unit admission (P < .0001). A lower risk of death was found in females (OR, .44; 95% CI, .34-.58) after adjusting for age and coexisting diseases. Among females, age, malignancy, chronic kidney disease, and days from onset to admission were significantly associated with mortality, while chronic kidney disease was not a risk factor in males.
Significantly milder illness and fewer deaths were found in female COVID-19 inpatients and risk factors associated with mortality varied among males and females.
随着 2019 年冠状病毒病（COVID-19）在全球范围内的加速传播，评估性别特异性的临床特征和结局非常重要，这可能会影响公共卫生政策。
对 2020 年 1 月 18 日至 3 月 27 日期间入住同济医院的 COVID-19 患者进行评估。比较了女性和男性之间的临床特征、实验室数据、并发症和结局。分别确定了全人群、女性和男性的死亡危险因素。
在 3309 例患者中，有 1667 例（50.38%）为女性。女性死亡率为 5.9%，而男性为 12.7%。与男性相比，更多的女性没有初始症状（11.1%比 8.3%，P=0.008）。女性并发症较少，包括急性呼吸窘迫综合征、急性肾损伤、感染性休克、心脏损伤和凝血障碍；危重病也明显较少（31.1%比 39.4%，P<0.0001）。女性接受抗生素治疗（P=0.001）、抗病毒治疗（P=0.025）、糖皮质激素治疗（P<0.0001）、机械通气（P<0.0001）和入住重症监护病房（P<0.0001）的比例明显较低。在校正年龄和并存疾病后，女性死亡风险降低（OR，0.44；95%CI，0.34-0.58）。在女性中，年龄、恶性肿瘤、慢性肾脏病和发病至入院天数与死亡率显著相关，而慢性肾脏病不是男性的危险因素。
女性 COVID-19 住院患者的病情明显较轻，死亡人数较少，且男性和女性的死亡危险因素不同。
