Sex differences in a cohort of COVID-19 Italian patients hospitalized during the first and second pandemic waves.

Abstract

Background: Coronavirus Disease 2019 (COVID-19) severity seems to be influenced by genetic background, sex, age, and presence of specific comorbidities. So far, little attention has been paid to sex-specific variations of demographic, clinical and laboratory features of COVID-19 patients referred to the same hospital in the two consecutive pandemic waves.Methods: Demographic, clinical and laboratory data were collected in 1,000 COVID-19 patients (367 females and 633 males), 500 hospitalized in the first wave and 500 in the second one, at the ASST Spedali Civili of Brescia from March to December 2020. Statistical analyses have been employed to compare data obtained in females and males, taking into account their age, and during the first and second COVID-19 waves. Results: The mean age at the time of hospitalization was similar in females and males but was significantly higher for both in the second wave; the time elapsed from symptoms onset to hospital admission did not differ between sexes in the two waves and no correlation was observed between delayed hospital admission and length of hospitalization. The number of multi-symptomatic males was higher than that of females and patients with a higher number of comorbidities were more frequently admitted to intensive care unit (ICU) and more frequently died. Older males remained in ICU longer than females and showed a longer disease duration, mainly the first wave. The highest levels of white blood cells, neutrophils, C-reactive protein and fibrinogen were significantly higher in males and in the first, and along with higher levels of D-dimer, ferritin, lactate dehydrogenase and procalcitonin which were preferentially documented in patients requiring ICU or died. While the ICU death rate was higher in males, the overall death rate did not differ between the sexes; however, the deceased women were older.Conclusions: These data indicate that once patients were hospitalized, the risk of dying was similar between females and males. Therefore, future studies should aim at understanding the reasons why, for a given number of SARS-CoV-2 infection, less females develop the disease requiring hospitalization.

In-depth genetic characterization of the SARS-CoV-2 pandemic in a two-year frame in North Macedonia using second and third generation sequencing technologies

“…Despite the fact that comorbidities significantly contribute to the development of more severe clinical conditions as well as death, their percentage was comparable in both groups, thus the significant difference in mortality between males and females is not due to their preexisting medical conditions. Similar observations were made in different studies in Italy, USA and China (32)(33)(34), further supporting our finding that SARS-CoV-2 infected males are more at risk for worse outcomes and death. A meta-analysis revealed that age had a significant impact on the COVID-19 patient mortality, with an important cut-off point at age >50 and particularly >60 (35).…”

COVID 19 – Hospitalisierung in der ersten und zweiten Welle

“…Welle und hatten weniger Komorbiditäten [8]. In Italien war das Durchschnittsalter in der zweiten Welle signifikant höher und die Zahl der männlichen Patienten mit mehreren Symptomen war höher als die der weiblichen [9]. In den Niederlanden änderten sich die Merkmale der Patienten hinsichtlich Alter, Geschlecht und Körpergewicht nicht.…”

“…Welle. Dies steht im Einklang mit der Studie aus Hamburg [11] und den Daten aus Colmar, Frankreich [15], aber im Gegensatz zu anderen internationalen Berichten [8,9]. Bestimmte Komorbiditäten, die mit einem erhöhten Risiko für Krankenhausaufenthalte oder schwere Verläufe von COVID-19 einhergehen, wurden bereits in der 1.…”