Jirak Peter, Mirna Moritz, Van Almsick Vincent, Shomanova Zornitsa, Mahringer Magdalena, Lichtenauer Michael, Kopp Kristen, Topf Albert, Sieg Franz, Kraus Johannes, Gharibeh Sarah X, Hoppe Uta C, Fiedler Lukas, Larbig Robert, Pistulli Rudin, Motloch Lukas J, Dieplinger Anna-Maria
Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria.
Department of Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, 48149 Muenster, Germany.
J Pers Med. 2022 May 23;12(5):849. doi: 10.3390/jpm12050849.
Gender-specific differences in the outcome of COVID-19 patients requiring intensive care treatment have been reported. However, a potential association with ICU therapy remains elusive.
A total of 224 consecutive patients (63 women) treated for severe COVID-19 disease requiring mechanical ventilation were screened for the study. After propensity score matching for gender, 40 men and 40 women were included in the study. Comparative analysis was conducted for laboratory parameters, ICU therapy and complications (pulmonary embolism, thrombosis, stroke, and ventricular arrhythmias), and outcome (mortality).
Male patients had significantly higher levels of CRP ( = 0.012), interleukin-6 ( = 0.020) and creatinine ( = 0.027), while pH levels ( = 0.014) were significantly lower compared to females. Male patients had longer intubation times ( = 0.017), longer ICU stays ( = 0.022) and higher rates of catecholamine dependence ( = 0.037). Outcome, complications and ICU therapy did not differ significantly between both groups.
The present study represents the first matched comparison of male and female COVID-19 patients requiring intensive care treatment. After propensity matching, male patients still displayed a higher disease severity. This was reflected in higher rates of vasopressors, duration of ICU stay and duration of intubation. In contrast, no significant differences were observed in mortality rates, organ replacement therapy and complications during ICU stay.
已有报道称，需要重症监护治疗的COVID-19患者存在性别差异。然而，与ICU治疗的潜在关联仍不明确。
对总共224例因严重COVID-19疾病需要机械通气治疗的连续患者进行研究筛选。在按性别进行倾向得分匹配后，研究纳入了40名男性和40名女性。对实验室参数、ICU治疗及并发症（肺栓塞、血栓形成、中风和室性心律失常）以及结局（死亡率）进行了比较分析。
男性患者的CRP（P = 0.012）、白细胞介素-6（P = 0.020）和肌酐（P = 0.027）水平显著更高，而pH值水平（P = 0.014）显著低于女性。男性患者的插管时间更长（P = 0.017）、ICU住院时间更长（P = 0.022）且儿茶酚胺依赖率更高（P = 0.037）。两组之间的结局、并发症和ICU治疗无显著差异。
本研究是首次对需要重症监护治疗的男性和女性COVID-19患者进行匹配比较。在倾向得分匹配后，男性患者的疾病严重程度仍更高。这体现在血管升压药使用率更高、ICU住院时间和插管时间更长。相比之下，在死亡率、器官替代治疗及ICU住院期间的并发症方面未观察到显著差异。
