tetano
Editor, Senior Moderator
J Cardiovasc Med (Hagerstown)
. 2022 Apr 1;23(4):254-263.
doi: 10.2459/JCM.0000000000001261.
Sex-related differences in patients with coronavirus disease 2019: results of the Cardio-COVID-Italy multicentre study
Carlo Mario Lombardi[SUP] 1 [/SUP], Claudia Specchia[SUP] 2 [/SUP], Fabio Conforti[SUP] 3 [/SUP], Maria Teresa La Rovere[SUP] 4 [/SUP], Valentina Carubelli[SUP] 1 [/SUP], Piergiuseppe Agostoni[SUP] 5 6 [/SUP], Stefano Carugo[SUP] 7 [/SUP], Gian Battista Danzi[SUP] 8 [/SUP], Marco Guazzi[SUP] 9 10 [/SUP], Andrea Mortara[SUP] 11 [/SUP], Massimo Piepoli[SUP] 12 13 [/SUP], Italo Porto[SUP] 14 [/SUP], Gianfranco Sinagra[SUP] 15 [/SUP], Maurizio Volterrani[SUP] 16 [/SUP], Pietro Ameri[SUP] 14 [/SUP], Massimiliano Gnecchi[SUP] 17 18 [/SUP], Sergio Leonardi[SUP] 17 18 [/SUP], Marco Merlo[SUP] 15 [/SUP], Annamaria Iorio[SUP] 19 [/SUP], Antonio Bellasi[SUP] 20 [/SUP], Claudia Canale[SUP] 14 [/SUP], Rita Camporotondo[SUP] 17 [/SUP], Francesco Catagnano[SUP] 11 [/SUP], Laura Adelaide Dalla Vecchia[SUP] 21 [/SUP], Mattia Di Pasquale[SUP] 1 [/SUP], Stefano Giovinazzo[SUP] 14 [/SUP], Gloria Maccagni[SUP] 1 [/SUP], Massimo Mapelli[SUP] 5 6 [/SUP], Davide Margonato[SUP] 11 22 [/SUP], Luca Monzo[SUP] 23 24 [/SUP], Vincenzo Nuzzi[SUP] 15 [/SUP], Chiara Oriecuia[SUP] 2 25 [/SUP], Laura Pala[SUP] 3 [/SUP], Giulia Peveri[SUP] 2 6 [/SUP], Andrea Pozzi[SUP] 19 [/SUP], Giovanni Provenzale[SUP] 7 [/SUP], Filippo Sarullo[SUP] 26 [/SUP], Marianna Adamo[SUP] 27 [/SUP], Daniela Tomasoni[SUP] 1 [/SUP], Riccardo Maria Inciardi[SUP] 1 [/SUP], Michele Senni[SUP] 19 [/SUP], Marco Metra[SUP] 1 [/SUP]
Affiliations
Abstract
Introduction: The role of sex compared to comorbidities and other prognostic variables in patients with coronavirus disease (COVID-19) is unclear.
Methods: This is a retrospective observational study on patients with COVID-19 infection, referred to 13 cardiology units. The primary objective was to assess the difference in risk of death between the sexes. The secondary objective was to explore sex-based heterogeneity in the association between demographic, clinical and laboratory variables, and patients' risk of death.
Results: Seven hundred and one patients were included: 214 (30.5%) women and 487 (69.5%) men. During a median follow-up of 15 days, deaths occurred in 39 (18.2%) women and 126 (25.9%) men. In a multivariable Cox regression model, men had a nonsignificantly higher risk of death vs. women (P = 0.07).The risk of death was more than double in men with a low lymphocytes count as compared with men with a high lymphocytes count [overall survival hazard ratio (OS-HR) 2.56, 95% confidence interval (CI) 1.72-3.81]. In contrast, lymphocytes count was not related to death in women (P = 0.03).Platelets count was associated with better outcome in men (OS-HR for increase of 50 × 103 units: 0.88 95% CI 0.78-1.00) but not in women. The strength of association between higher PaO2/FiO2 ratio and lower risk of death was larger in women (OS-HR for increase of 50 mmHg/%: 0.72, 95% CI 0.59-0.89) vs. men (OS-HR: 0.88, 95% CI 0.80-0.98; P = 0.05).
Conclusions: Patients' sex is a relevant variable that should be taken into account when evaluating risk of death from COVID-19. There is a sex-based heterogeneity in the association between baseline variables and patients' risk of death.
. 2022 Apr 1;23(4):254-263.
doi: 10.2459/JCM.0000000000001261.
Sex-related differences in patients with coronavirus disease 2019: results of the Cardio-COVID-Italy multicentre study
Carlo Mario Lombardi[SUP] 1 [/SUP], Claudia Specchia[SUP] 2 [/SUP], Fabio Conforti[SUP] 3 [/SUP], Maria Teresa La Rovere[SUP] 4 [/SUP], Valentina Carubelli[SUP] 1 [/SUP], Piergiuseppe Agostoni[SUP] 5 6 [/SUP], Stefano Carugo[SUP] 7 [/SUP], Gian Battista Danzi[SUP] 8 [/SUP], Marco Guazzi[SUP] 9 10 [/SUP], Andrea Mortara[SUP] 11 [/SUP], Massimo Piepoli[SUP] 12 13 [/SUP], Italo Porto[SUP] 14 [/SUP], Gianfranco Sinagra[SUP] 15 [/SUP], Maurizio Volterrani[SUP] 16 [/SUP], Pietro Ameri[SUP] 14 [/SUP], Massimiliano Gnecchi[SUP] 17 18 [/SUP], Sergio Leonardi[SUP] 17 18 [/SUP], Marco Merlo[SUP] 15 [/SUP], Annamaria Iorio[SUP] 19 [/SUP], Antonio Bellasi[SUP] 20 [/SUP], Claudia Canale[SUP] 14 [/SUP], Rita Camporotondo[SUP] 17 [/SUP], Francesco Catagnano[SUP] 11 [/SUP], Laura Adelaide Dalla Vecchia[SUP] 21 [/SUP], Mattia Di Pasquale[SUP] 1 [/SUP], Stefano Giovinazzo[SUP] 14 [/SUP], Gloria Maccagni[SUP] 1 [/SUP], Massimo Mapelli[SUP] 5 6 [/SUP], Davide Margonato[SUP] 11 22 [/SUP], Luca Monzo[SUP] 23 24 [/SUP], Vincenzo Nuzzi[SUP] 15 [/SUP], Chiara Oriecuia[SUP] 2 25 [/SUP], Laura Pala[SUP] 3 [/SUP], Giulia Peveri[SUP] 2 6 [/SUP], Andrea Pozzi[SUP] 19 [/SUP], Giovanni Provenzale[SUP] 7 [/SUP], Filippo Sarullo[SUP] 26 [/SUP], Marianna Adamo[SUP] 27 [/SUP], Daniela Tomasoni[SUP] 1 [/SUP], Riccardo Maria Inciardi[SUP] 1 [/SUP], Michele Senni[SUP] 19 [/SUP], Marco Metra[SUP] 1 [/SUP]
Affiliations
- PMID: 35287158
- DOI: 10.2459/JCM.0000000000001261
Abstract
Introduction: The role of sex compared to comorbidities and other prognostic variables in patients with coronavirus disease (COVID-19) is unclear.
Methods: This is a retrospective observational study on patients with COVID-19 infection, referred to 13 cardiology units. The primary objective was to assess the difference in risk of death between the sexes. The secondary objective was to explore sex-based heterogeneity in the association between demographic, clinical and laboratory variables, and patients' risk of death.
Results: Seven hundred and one patients were included: 214 (30.5%) women and 487 (69.5%) men. During a median follow-up of 15 days, deaths occurred in 39 (18.2%) women and 126 (25.9%) men. In a multivariable Cox regression model, men had a nonsignificantly higher risk of death vs. women (P = 0.07).The risk of death was more than double in men with a low lymphocytes count as compared with men with a high lymphocytes count [overall survival hazard ratio (OS-HR) 2.56, 95% confidence interval (CI) 1.72-3.81]. In contrast, lymphocytes count was not related to death in women (P = 0.03).Platelets count was associated with better outcome in men (OS-HR for increase of 50 × 103 units: 0.88 95% CI 0.78-1.00) but not in women. The strength of association between higher PaO2/FiO2 ratio and lower risk of death was larger in women (OS-HR for increase of 50 mmHg/%: 0.72, 95% CI 0.59-0.89) vs. men (OS-HR: 0.88, 95% CI 0.80-0.98; P = 0.05).
Conclusions: Patients' sex is a relevant variable that should be taken into account when evaluating risk of death from COVID-19. There is a sex-based heterogeneity in the association between baseline variables and patients' risk of death.