Male gender is a predictor of higher mortality in hospitalized adults with COVID-19

Abstract

Introduction The coronavirus disease 2019 (COVID-19) pandemic continues to be a global threat, with tremendous resources invested into identifying risk factors for severe COVID-19 illness. The objective of this study was to analyze the characteristics and outcomes of male compared to female adults with COVID-19 who required hospitalization within US academic centers. Methods Using the Vizient clinical database, discharge records of adults with a diagnosis of COVID-19 between March 1, 2020 and November 30, 2020 were reviewed. Outcome measures included demographics, characteristics, length of hospital stay, rate of respiratory intubation and mechanical ventilation, and rate of in-hospital mortality of male vs female according to age, race/ethnicity, and presence of preexisting comorbidities. Results Among adults with COVID-19, 161,206 were male while 146,804 were female. Adult males with COVID-19 were more likely to have hypertension (62.1% vs 59.6%, p <0.001%), diabetes (39.2% vs 36.0%, p <0.001%), renal failure (22.3% vs 18.1%, p <0.001%), congestive heart failure (15.3% vs 14.6%, p <0.001%), and liver disease (5.9% vs 4.5%, p <0.001%). Adult females with COVID-19 were more likely to be obese (32.3% vs 25.7%, p<0.001) and have chronic pulmonary disease (23.7% vs 18.1%, p <0.001). Gender was significantly different among races (p<0.001), and there was a lower proportion of males versus females in African American patients with COVID-19. Comparison in outcomes of male vs. female adults with COVID-19 is depicted in Table 2. Compared to females, males with COVID-19 had a higher rate of in-hospital mortality (13.8% vs 10.2%, respectively, p <0.001); a higher rate of respiratory intubation (21.4% vs 14.6%, p <0.001); and a longer length of hospital stay (9.5 ± 12.5 days vs. 7.8 ± 9.8 days, p<0.001). In-hospital mortality analyzed according to age groups, race/ethnicity, payers, and presence of preexisting comorbidities consistently showed higher death rate among males compared to females (Table 2). Adult males with COVID-19 were associated with higher odds of mortality compared to their female counterparts across all age groups, with the effect being most pronounced in the 18–30 age group (OR, 3.02 [95% CI, 2.41–3.78]). Conclusion This large analysis of 308,010 COVID-19 adults hospitalized at US academic centers showed that males have a higher rate of respiratory intubation and longer length of hospital stay compared to females and have a higher death rate even when compared across age groups, race/ethnicity, payers, and comorbidity.

Prognostic Role of Anemia in COVID-19 Patients: A Meta-Analysis

“…To this regard, it has been already reported that rates of anemia in men increased monotonically with age, while that of women increased bimodally with peaks in age groups 40–49 years and 80–85 years [ 19 ]. Furthermore, older COVID-19 patients have a higher risk of mortality, but in this case, women with anemia seem to have a worse outcome compared to males who generally have been reported to be at higher risk of death [ 20 ]. This difference can be explained by considering that some research has shown that the risk for CKD is slightly greater in women than in men [ 21 ] and that prominent gender disparities in CKD prevalence do exist among different countries [ 22 ].…”

Prognostic Role of Metabolic Syndrome in COVID-19 Patients: A Systematic Review Meta-Analysis

“…To further appraise the impact of potential baseline confounders, a meta-regression analysis using age, gender, HT, DM, chronic pulmonary disease and hyperlipidaemia as moderator variables was performed. These variables were selected since previous analyses have identified those comorbidities as independent predictors of mortality in COVID-19 patients [2,3,10,11]. All meta-analyses were conducted using Comprehensive Meta-Analysis software, version 3 (Biostat, Englewood, NJ, USA).…”

Factors That Influence Mortality in Critically Ill Patients with SARS-CoV-2 Infection: A Multicenter Study in the Kingdom of Saudi Arabia

“…Multiple studies have addressed clinical outcomes in COVID-19 patients: many of them have shown a correlation of mortality with advanced age and male gender; some have shown an association with smoking and certain chronic comorbidities, such as underlying diabetes mellitus, chronic renal insufficiency, chronic obstructive lung disease, and cardiovascular diseases; some have addressed clinical parameters, such as the severity of respiratory failure [ 8 ] and acute renal failure; and others have addressed laboratory investigations as predictors of outcome and found significant correlations with certain inflammatory markers, such as high-sensitivity C-reactive protein, D dimer, and procalcitonin [ 9 , 10 , 11 , 12 ].…”