In a new study, researchers confirmed that men with COVID-19 have worse outcomes than women, possibly related to them experiencing higher levels of inflammation.
They found that men have a 62% increased risk of COVID-19 associated death compared with women, after adjustment for various factors.
The research was conducted by a team at the University Hospital Regensburg, Germany.
Increasing evidence suggests a gender difference in COVID-19 infections.
In most studies, men are overrepresented and previously published data show a higher incidence of severe courses of COVID-19 in men.
To collect clinical data from the pandemic, the international multicenter Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) registry was established.
In this study, the team presented a first analysis of the LEOSS dataset on the impact of sex in COVID-19.
They assessed 3,129 adult patients with COVID-19, enrolled between March and July 2020.
Clinical manifestation of COVID-19 was described in four phases: uncomplicated (asymptomatic/mild symptoms), complicated (need for oxygen supplementation), critical (need for critical care), and recovery.
Symptoms, vital signs, inflammatory markers, and therapeutic interventions were analyzed over all phases as was the clinical outcome.
The male: female ratio in this mostly hospital-based cohort was 1.48 with a male predominance in all age groups.
Male predominance was even more pronounced in the age groups >65 years and >75 years.
Mean CCI and most comorbidities did not differ significantly between men and women, while coronary artery disease (18% vs 10%) and smoking rates were higher in male patients (14.5 vs 10.5%) than female patients.
Progression to a critical phase (generally reflecting ICU admission) was seen more often in men than in women (30.6% vs 17.2%).
The mean hospital length of stay was longer in male patients (15.4 vs 13.3 days).
Both crude mortality (19.2% vs 12.9%) and COVID-19 attributable mortality (17.1% vs 10.3%, figure 1, e-poster), were significantly higher in men.
Being male proved to be an independent risk factor for a 62% increased risk of COVID-19 associated death.
While most laboratory parameters were comparable between male and female patients with COVID-19, men had significantly higher inflammatory markers (IL-6, CRP, PCT, ferritin) across all phases of disease (figure 3, e-poster).
The researchers concluded that men are more likely to progress to critical phases of COVID-19.
Men have higher death rates as well as more frequent ICU admissions and longer hospital stays, which are all associated with higher inflammation during all phases of COVID-19.
One author of the study is Dr. Frank Hanses.
The study was presented at the ESCMID Conference on Coronavirus Disease.
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