Rola Piotr, Doroszko Adrian, Trocha Małgorzata, Giniewicz Katarzyna, Kujawa Krzysztof, Skarupski Marek, Gajecki Damian, Gawryś Jakub, Matys Tomasz, Szahidewicz-Krupska Ewa, Adamik Barbara, Kaliszewski Krzysztof, Kiliś-Pstrusińska Katarzyna, Matera-Witkiewicz Agnieszka, Pomorski Michał, Protasiewicz Marcin, Madziarski Marcin, Chrostek Urszula, Radzik-Zając Joanna, Radlińska Anna, Zaleska Anna, Letachowicz Krzysztof, Pisarek Wojciech, Barycki Mateusz, Sokołowski Janusz, Jankowska Ewa Anita, Madziarska Katarzyna
Department of Cardiology Provincial Specialized Hospital Iwaszkiewicza 5 Str., 59-220 Legnica, Poland.
Clinical Departmentof Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
Viruses. 2022 Mar 17;14(3):628. doi: 10.3390/v14030628.
Since the outbreak of the COVID-19 pandemic, a growing number of evidence suggests that COVID-19 presents sex-dependent differences in clinical course and outcomes. Nevertheless, there is still an unmet need to stratify the risk for poor outcome at the beginning of hospitalization. Since individual CHEST components are similar COVID-19 mortality risk factors, we evaluated sex-related predictive value of the score. A total of 2183 medical records of consecutive patients hospitalized due to confirmed SARS-CoV-2 infections were analyzed. Subjects were assigned to one of two of the study arms (male vs. female) and afterward allocated to different stratum based on the CHEST score result. The measured outcomes included: -mortality, and all-cause-mortality and non-fatal adverse clinical events. The CHEST score predicted the mortality with better sensitivity in female population regarding the short- and mid-term. Among secondary outcomes, CHEST-score revealed predictive value in both genders for pneumonia, myocardial injury, myocardial infarction, acute heart failure, cardiogenic shock, and acute kidney injury. Additionally in the male cohort, the CHEST value predicted acute liver dysfunction and all-cause bleeding, whereas in the female arm-stroke/TIA and SIRS. In the present study, we demonstrated the better CHEST-score predictive value for mortality in women and illustrated sex-dependent differences predicting non-fatal secondary outcomes.
自新冠疫情爆发以来，越来越多的证据表明，新冠病毒感染在临床病程和结局方面存在性别差异。然而，在住院初期对预后不良风险进行分层的需求仍未得到满足。由于CHEST评分的各个组成部分都是相似的新冠病毒感染死亡风险因素，我们评估了该评分与性别的预测价值。我们分析了2183例因确诊感染SARS-CoV-2而连续住院患者的病历。将受试者分为两个研究组之一（男性组与女性组），然后根据CHEST评分结果分配到不同分层。测量的结局包括：死亡率、全因死亡率和非致命性不良临床事件。CHEST评分在女性人群中对短期和中期死亡率的预测敏感性更高。在次要结局中，CHEST评分在男女两性中对肺炎、心肌损伤、心肌梗死、急性心力衰竭、心源性休克和急性肾损伤均显示出预测价值。此外，在男性队列中，CHEST评分可预测急性肝功能障碍和全因出血，而在女性队列中可预测中风/短暂性脑缺血发作和全身炎症反应综合征。在本研究中，我们证明了CHEST评分对女性死亡率具有更好的预测价值，并阐明了在预测非致命性次要结局方面的性别差异。
