Cañón-Estrada Frank, Muñoz-Ordoñez Juan Andrés, Escalante-Forero Manuela, Rodas Yorlany, Arteaga-Tobar Andrea Alejandra, Azcarate-Rodriguez Valeria, Perna Eduardo, Mendoza Iván, Wyss Fernando, Barisani José Luis, Speranza Mario, Alarco Walter, Ortega Juan Carlos, Ulate Andrés, Mercedes Jessica, Chaves Daniel Quesada, Oliver Paola, Valencia-Orozco Andrea, Barbosa Mario Miguel, León-Giraldo Hoover, Flórez Noel Alberto, Gómez-Mesa Juan Esteban
Facultad de Ciencias de La Salud, Universidad Icesi, 76003, Cali, Colombia.
Centro de Investigaciones Clínicas, Fundación Valle del Lili, 76003, Cali, Colombia.
BMC Cardiovasc Disord. 2025 Mar 5;25(1):147. doi: 10.1186/s12872-025-04565-3.
The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex.
To compare clinical data, biochemical biomarkers, and outcomes among hospitalized COVID-19 patients in Latin America and the Caribbean (LA&C) based on sex and to perform a cluster analysis of biomarker profiles for both sexes.
This prospective, multicenter observational registry made by the Inter-American Council of Heart Failure and Pulmonary Hypertension of the Inter-American Society of Cardiology included hospitalized COVID-19 patients from 44 hospitals in 14 countries in LA&C between May 1, 2020, and June 30, 2021.
Of 3,260 patients (1,201 females and 2,059 males), males had higher C-reactive protein and ferritin levels, while females had higher natriuretic peptides and d-dimer levels. Males had more cardiovascular complications (acute coronary syndrome [3.3% vs. 2.2%], decompensated heart failure [8.9% vs. 7.8%], pulmonary embolism [4.4% vs. 2.9%]), intensive care unit (ICU) admissions (56.9% vs. 47.7%), and overall mortality (27.5% vs. 22.1%). Cluster analysis identified three groups: one with normal-range biomarkers but elevated ferritin, one with coagulation abnormalities, and one with an inflammatory profile linked to renal injury and increased non-cardiovascular mortality.
In the LA&C population hospitalized with COVID-19, males had higher inflammatory biomarker levels, correlating with increased cardiovascular complications and mortality. The cluster with an inflammatory profile showed higher non-cardiovascular mortality, while clusters with elevated ferritin levels were associated with increased ICU admissions.
与新型冠状病毒肺炎（COVID-19）相关的炎症反应因性别而异，这可能会影响疾病的预后。与女性相比，男性发生并发症的风险更高，因此需要评估基于性别的炎症反应严重程度差异。
比较拉丁美洲和加勒比地区（LA&C）住院COVID-19患者基于性别的临床数据、生化生物标志物和预后，并对两性的生物标志物谱进行聚类分析。
这项前瞻性、多中心观察性登记研究由美洲心脏病学会心力衰竭和肺动脉高压美洲理事会开展，纳入了2020年5月1日至2021年6月30日期间LA&C 14个国家44家医院的住院COVID-19患者。
在3260例患者（1201例女性和2059例男性）中，男性的C反应蛋白和铁蛋白水平较高，而女性的利钠肽和D-二聚体水平较高。男性发生心血管并发症（急性冠状动脉综合征[3.3%对2.2%]、失代偿性心力衰竭[8.9%对7.8%]、肺栓塞[4.4%对2.9%]）、入住重症监护病房（ICU）（56.9%对47.7%）和总体死亡率（27.5%对22.1%）的比例更高。聚类分析确定了三组：一组生物标志物在正常范围内但铁蛋白升高，一组有凝血异常，一组有与肾损伤和非心血管死亡率增加相关的炎症特征。
在LA&C地区因COVID-19住院的人群中，男性的炎症生物标志物水平较高，这与心血管并发症和死亡率增加相关。具有炎症特征的聚类显示非心血管死亡率较高，而铁蛋白水平升高的聚类与入住ICU的比例增加相关。
