Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.
Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università di Milano, Milan, Italy.
J Med Virol. 2021 Jul;93(7):4597-4602. doi: 10.1002/jmv.26933. Epub 2021 Mar 26.
Biological sex could affect the natural history of severe acute respiratory syndrome coronavirus 2 infection. We enrolled all COVID-19 patients admitted to two COVID-19 hospitals in Milan in a prospective observational study. The primary outcome was death during the study period and the secondary outcome was critical disease at hospital admission. The association(s) between clinically relevant, noncollinear variables, and the primary outcome was assessed with uni- and multivariable Logistic regression models. A total of 520 patients were hospitalized of whom 349 (67%) were males with a median age 61 (interquartile range: 50-72). A higher proportion of males presented critically ill when compared to females (30.1% vs. 18.7%, p < .046). Death occurred in 86 (24.6%) males and 27 (15.8%) females (p = .024). In multivariable analysis age (per 10 years more) (adjusted odds ratio [AOR]: 1.83 [95% confidence interval {CI}: 1.42-2.35], p < .0001), obesity (AOR: 2.17 [95% CI: 1.10-4.31], p = .026), critical disease at hospital admission (AOR 6.34 [95% CI: 3.50-11.48], p < .0001) were independently associated to higher odds of death whereas gender was not. In conclusion, a higher proportion of males presented critically ill at hospital admission. Age, critical disease at hospital admission, obesity, anemia, D-dimer, estimated glomerular filtration rate, lactate dehydrogenase, and creatine kinase predicted death in hospitalized COVID-19 patients.
生物学性别可能会影响严重急性呼吸综合征冠状病毒 2 感染的自然史。我们在米兰的两家 COVID-19 医院对所有 COVID-19 患者进行了前瞻性观察研究。主要结局是研究期间的死亡,次要结局是入院时的危急疾病。使用单变量和多变量逻辑回归模型评估了与临床相关、非共线性变量与主要结局之间的关联。共收治 520 例患者,其中 349 例(67%)为男性,中位年龄 61(四分位距:50-72)。与女性相比,男性有更高比例的患者表现为危急疾病(30.1%对 18.7%,p<.046)。男性死亡 86 例(24.6%),女性死亡 27 例(15.8%)(p=.024)。多变量分析显示,年龄(每增加 10 岁)(校正比值比[OR]:1.83[95%可信区间{CI}:1.42-2.35],p<.0001)、肥胖(OR:2.17[95% CI:1.10-4.31],p=.026)、入院时的危急疾病(OR 6.34[95% CI:3.50-11.48],p<.0001)与死亡的几率较高独立相关,而性别则无关联。总之,男性在入院时表现为危急疾病的比例较高。年龄、入院时的危急疾病、肥胖、贫血、D-二聚体、估算肾小球滤过率、乳酸脱氢酶、肌酸激酶预测住院 COVID-19 患者的死亡。