The Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.
The Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.
Am J Cardiol. 2022 May 1;170:112-117. doi: 10.1016/j.amjcard.2022.01.024. Epub 2022 Mar 10.
Gender-specific differences in thrombosis have been reported in hospitalized patients with COVID-19. We sought to investigate the influence of age on the relation between gender and incident thrombosis or death in COVID-19. We identified consecutive adults aged ≥18 years hospitalized with COVID-19 from March 1, 2020, to April 17, 2020, at a large New York health system. In-hospital thrombosis and all-cause mortality were evaluated by gender and stratified by age group. Logistic regression models were generated to estimate the odds of thrombosis or death after multivariable adjustment. In 3,334 patients hospitalized with COVID-19, 61% were men. Death or thrombosis occurred in 34% of hospitalizations and was more common in men (36% vs 29% in women, p <0.001; adjusted odds ratio [aOR] 1.61, 95% confidence interval [CI] 1.36 to 1.91). When stratified by age, men had a higher incidence of death or thrombosis in younger patients (aged 18 to 54 years: 21% vs 9%, aOR 3.17, 95% CI 2.06 to 5.01; aged 55 to 74 years: 39% vs 28%, aOR 1.63, 95% CI 1.28 to 2.10), but not older patients (aged ≥75 years: 55% vs 48%; aOR 1.20, 95% CI 0.90 to 1.59) (interaction p value: 0.01). For the individual end points, men were at higher risk of thrombosis (19% vs 12%; aOR 1.65, 95% CI 1.33 to 2.05) and mortality (26% vs 23%; aOR 1.41, 95% CI 1.17 to 1.69) than women, and gender-specific differences were attenuated with older age. Associations between thrombosis and mortality were most striking in younger patients (aged 18 to 54 years, aOR 8.25; aged 55 to 74 years, aOR 2.38; aged >75 years, aOR 1.88; p for interaction <0.001) but did not differ by gender. In conclusion, the risk of thrombosis or death in COVID-19 is higher in men compared with women and is most apparent in younger age groups.
在住院的 COVID-19 患者中，已经报道了性别特异性血栓形成差异。我们试图研究年龄对 COVID-19 中性别与血栓形成或死亡事件之间关系的影响。我们在一家大型纽约医疗系统中，确定了 2020 年 3 月 1 日至 4 月 17 日期间年龄≥18 岁因 COVID-19 住院的连续成年人。通过性别评估院内血栓形成和全因死亡率，并按年龄组分层。使用多变量调整后生成逻辑回归模型来估计血栓形成或死亡的可能性。在 3334 名因 COVID-19 住院的患者中，61%为男性。34%的住院患者发生死亡或血栓形成，男性更为常见（男性为 36%，女性为 29%，p<0.001；调整后的优势比[aOR]1.61，95%置信区间[CI]1.36 至 1.91）。按年龄分层时，年轻患者（18 至 54 岁：21%比 9%，aOR 3.17，95%CI 2.06 至 5.01；55 至 74 岁：39%比 28%，aOR 1.63，95%CI 1.28 至 2.10）的男性死亡率或血栓形成发生率更高，但老年患者（≥75 岁：55%比 48%；aOR 1.20，95%CI 0.90 至 1.59）（交互 p 值：0.01）则不然。对于个别终点，男性发生血栓形成（19%比 12%；aOR 1.65，95%CI 1.33 至 2.05）和死亡（26%比 23%；aOR 1.41，95%CI 1.17 至 1.69）的风险均高于女性，且这种性别差异随年龄增长而减弱。在年轻患者（18 至 54 岁，aOR 8.25；55 至 74 岁，aOR 2.38；年龄>75 岁，aOR 1.88；p 交互<0.001）中，血栓形成与死亡率之间的关联最为明显，但与性别无关。总之，COVID-19 患者中男性发生血栓形成或死亡的风险高于女性，在年轻人群中更为明显。
