Infectious Disease

Males who usually tend to check optimistic for COVID-19 have worse outcomes

January 27, 2021

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Men test positive for COVID-19 more often than women and, according to the research published in PLoS One, require admission to the intensive care unit, mechanical ventilation and hospital mortality with the novel coronavirus.

“While gender-specific behaviors such as smoking, drinking, inclination to hospital care, and the presence of comorbidities can influence the outcome of COVID-19, the increased risk of death in men in different cultures around the world suggests biological risk determinants” Farhaan S. Vahidy, PhD, MBBS, MPH, FAHA, The Assistant Director of the Center for Outcomes Research at Houston Methodist and colleagues wrote. “Despite these preliminary studies, a comprehensive analysis of the gender differences in the epidemiological characteristics of COVID-19 disease from a large and diverse metropolitan area of ​​the United States is lacking.”

Reference: Vahidy FS et al. Plus one. 2021; doi: 10.1371 / journal.pone.0245556.

Vahidy and colleagues performed a cross-sectional analysis of data from an observational research registry of patients with COVID-19 seeking treatment within the Houston Methodist healthcare system. The registry collects data on socio-demographic factors, clinical information, comorbidities and patient outcomes.

Adults who tested positive for SARS-CoV-2 using polymerized chain reaction tests from March 6, 2020 to August 22, 2020 were included in the study.

Of 96,473 patients, 14,992 tested positive for COVID-19 during the study period. Of these patients, 31.9% were hospitalized and 9.5% died.

The researchers found that the proportion of male patients who tested positive (17.0%; 16.6–17.3) was higher than the proportion of female patients who tested positive (14.6%; 14.3-14.9) (OR = 1.20; 95% CI, 1.16-) 1.24). After adjusting for age, race, insurance type, income, BMI, smoking status and comorbidities, Vahidy and colleagues found that men tested positive for SARS-CoV-2 significantly more often than women (aOR = 1.39; 95% CI, 1, 33) -1.45).

Of the patients admitted to the hospital, 30.9% were treated in the intensive care unit. According to the researchers, the proportion of male intensive care patients (34.1%; 32.2–36) was significantly higher than that of women (27.6%; 25.8–29.5) (OR = 1.36; 1.20– 1.53). They found that this finding remained similar after adjustments (aOR = 1.31; 95% CI, 1.13–1.51).

Vahidy and colleagues found that the proportion of men hospitalized with COVID-19 who required invasive mechanical ventilation (19.0%; 17.5-20.6) compared to women (14.7%; 13.3–16.2) was significantly higher (OR = 1.36; 95% CI, 1.17–1.59). The proportion of men remained significantly higher after adjustments (aOR = 1.29; 95% CI, 1.08–1.55).

The proportion of patients with in-hospital mortality was also significantly higher in men (11.6%; 10.4–13.0) than in women (8.3%; 7.3–9.6) (OR = 1, 44; 95% CI, 1.18-1.75). and this remained significant after adjusting for socio-demographic characteristics, comorbidities, and other factors (aOR = 1.45; 95% CI, 1.06–2.00).

Vahidy and colleagues wrote that the study “shows a higher risk of SARS-CoV-2 prognosis and severe COVID-19 outcomes in men, and underscores the importance of further exploring the biological pathways that may influence causation”.

“Sex is increasingly recognized as a modifier of disease, and its role in relation to SARS-CoV-2 and COVID19 appears to be no exception,” they wrote.

They added that “differences in immune response may explain gender differences, but further study is needed to identify more robust strategies for patient risk stratification and targeted treatment interventions.”

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