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COVID-19 住院患者的表现和结局的性别差异。

Gender Differences in the Presentation and Outcomes of Hospitalized Patients With COVID-19.

机构信息

Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano (Turin), Italy.

Hospital Clínico San Carlos, Madrid, Spain.

出版信息

J Hosp Med. 2021 Jun;16(6):349-352. doi: 10.12788/jhm.3594.

Abstract

Gender-related differences in COVID-19 clinical presentation, disease progression, and mortality have not been adequately explored. We analyzed the clinical profile, presentation, treatments, and outcomes of patients according to gender in the HOPE-COVID-19 International Registry. Among 2,798 enrolled patients, 1,111 were women (39.7%). Male patients had a higher prevalence of cardiovascular risk factors and more comorbidities at baseline. After propensity score matching, 876 men and 876 women were selected. Male patients more often reported fever, whereas female patients more often reported vomiting, diarrhea, and hyposmia/anosmia. Laboratory tests in men presented alterations consistent with a more severe COVID-19 infection (eg, significantly higher C-reactive protein, troponin, transaminases, lymphocytopenia, thrombocytopenia, and ferritin). Systemic inflammatory response syndrome, bilateral pneumonia, respiratory insufficiency, and renal failure were significantly more frequent in men. Men more often required pronation, corticosteroids, and tocilizumab administration. A significantly higher 30-day mortality was observed in men vs women (23.4% vs 19.2%; P = .039). Trial Numbers: NCT04334291/EUPAS34399.

摘要

性别与 COVID-19 的临床表现、疾病进展和死亡率之间的差异尚未得到充分研究。我们根据性别分析了 HOPE-COVID-19 国际注册研究中的患者的临床特征、表现、治疗方法和结局。在纳入的 2798 名患者中,有 1111 名女性(39.7%)。男性患者在基线时更常见心血管危险因素和更多合并症。经过倾向评分匹配后,选择了 876 名男性和 876 名女性。男性患者更常报告发热,而女性患者更常报告呕吐、腹泻和嗅觉减退/丧失。男性患者的实验室检查显示出与更严重 COVID-19 感染一致的改变(例如,显著更高的 C 反应蛋白、肌钙蛋白、转氨酶、淋巴细胞减少、血小板减少和铁蛋白)。全身炎症反应综合征、双侧肺炎、呼吸功能不全和肾衰竭在男性中更为常见。男性更常需要翻身、皮质类固醇和托珠单抗治疗。男性的 30 天死亡率显著高于女性(23.4%比 19.2%;P=.039)。试验编号:NCT04334291/EUPAS34399。

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