Sex Differences in Coronavirus Disease 2019 (COVID-19) Hospitalization and Mortality

Gomez, Joanne Michelle D.; Lavallaz, Jeanne du Fay de; Fugar, Setri; Sarau, Alexandra; Simmons, Jessica; Clark, Brian; Sanghani, Rupa; Aggarwal, Neelum T.; Williams, Kim A.; Doukky, Rami; Volgman, Annabelle Santos

doi:10.1089/jwh.2020.8948

Cited by 86 publications

(78 citation statements)

References 29 publications

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“…Similar patterns were noted in the study of COVID-19 mortality in Massachusetts (17). Our findings reflect a growing body of literature documenting a disproportionate burden of severe and fatal COVID-19 cases among men and racial/ethnic minorities (19)(20)(21)(22)(23)(24)(25). It is important to note that the occupational disparities in COVID-19 fatalities that we found could not be attributed solely to differences in employment by sex or race/ethnicity.…”

Section: Discussionsupporting

confidence: 83%

Disparities in COVID-19 Fatalities among Working Californians

Cummings

Beckman

Frederick

et al. 2021

Preprint

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BackgroundInformation on the occupational distribution of COVID-19 mortality is limited.ObjectiveTo characterize COVID-19 fatalities among working Californians.DesignRetrospective study of laboratory-confirmed COVID-19 fatalities with dates of death from January 1 to December 31, 2020.SettingCalifornia.ParticipantsCOVID-19 accounted for 8,050 (9.9%) of 81,468 fatalities among Californians 18-64 years old. Of these decedents, 2,486 (30.9%) were matched to state employment records and classified as “confirmed working.” The remainder were classified as “likely working” (n=4,121 [51.2%]) or “not working” (n=1,443 [17.9%]) using death certificate and case registry data.MeasurementsWe calculated age-adjusted overall and occupation-specific COVID-19 mortality rates using 2019 American Community Survey denominators.ResultsConfirmed and likely working COVID-19 decedents were predominantly male (76.3%), Latino (68.7%), and foreign-born (59.6%), with high school or less education (67.9%); 7.8% were Black. The overall age-adjusted COVID-19 mortality rate was 30.0 per 100,000 workers (95% confidence interval [CI], 29.3-30.8). Workers in nine occupational groups had mortality rates higher than this overall rate, including those in farming (78.0; 95% CI, 68.7-88.2); material moving (77.8; 95% CI, 70.2-85.9); construction (62.4; 95% CI, 57.7-67.4); production (60.2; 95% CI, 55.7-65.0); and transportation (57.2; 95% CI, 52.2-62.5) occupations. While occupational differences in mortality were evident across demographic groups, mortality rates were three-fold higher for male compared with female workers and three- to seven-fold higher for Latino and Black workers compared with Asian and White workers.LimitationsThe requirement that fatalities be laboratory-confirmed and the use of 2019 denominator data may underestimate the occupational burden of COVID-19 mortality.ConclusionCalifornians in manual labor and in-person service occupations experienced disproportionate COVID-19 mortality, with the highest rates observed among male, Latino, and Black workers.

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Section: Discussionsupporting

confidence: 83%

Disparities in COVID-19 Fatalities among Working Californians

Cummings

Beckman

Frederick

et al. 2021

Preprint

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“…We focus the attention of this paper on quantifying disparities in population-level COVID-19 mortality. Substantial scientific research has uncovered disparities in COVID-19 mortality outcomes in the U.S. by race/ethnicity (e.g., (3, 4, 5, 6, 7, 8, 9, 10, 11)), as well as between males and females (e.g., (12, 13, 14, 15, 16, 17, 18, 19)). However, research on U.S. population-level disparities in COVID-19 mortality outcomes across the intersection of race/ethnicity and sex has been limited, largely due to the absence of requisite publicly available data, which represents a critical research gap in the quantification and understanding of the nature of population-level disparities in COVID-19 mortality outcomes between subgroups.…”

Section: Introductionmentioning

confidence: 99%

National Population-Level Disparities in COVID-19 Mortality Across the Intersection of Race/Ethnicity and Sex in the United States

Chen

Belin

et al. 2021

Preprint

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Males and certain racial/ethnic minority groups have borne a disproportionate burden of COVID-19 mortality in the United States, and substantial scientific research has sought to quantify and characterize population-level disparities in COVID-19 mortality outcomes by sex and across categories of race/ethnicity. However, there has not yet been a national population-level study to quantify disparities in COVID-19 mortality outcomes across the intersection of these demographic dimensions. Here, we analyze a publicly available dataset from the National Center for Health Statistics comprising COVID-19 death counts stratified by race/ethnicity, sex, and age for the year 2020, calculating mortality rates for each race/ethnicity-sex-age stratum and age-adjusted mortality rates for each race/ethnicity-sex stratum, quantifying disparities in terms of mortality rate ratios and rate differences. Our results reveal persistently higher COVID-19 age-adjusted mortality rates for males compared to females within every racial/ethnic group, with notable variation in the magnitudes of the sex disparity by race/ethnicity. However, non-Hispanic Black, Hispanic, and non-Hispanic American Indian or Alaska Native females have higher age-adjusted mortality rates than non-Hispanic White and non-Hispanic Asian/Pacific Islander males. Moreover, persistent racial/ethnic disparities are observed among both males and females, with higher COVID-19 age-adjusted mortality rates observed for non-Hispanic Blacks, Hispanics, and non-Hispanic American Indian or Alaska Natives relative to non-Hispanic Whites.

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“…Hospital mortality is estimated to be less than 5% for individuals younger than 40 years, 35% for patients aged 70 to79 years, and more than 60% for people 80 to 89 years of age [ 4 ]. Concerning sex, a similar mortality pattern was reported in Europe, while a study carried out in the US showed that male sex was independently associated with death, hospitalization, and intensive care unit admissions [ 5 , 6 ]. Individuals undergoing kidney transplants or dialysis; and patients with cancer, diabetes, and neurologic or cardiovascular diseases are suggested to be at increased risk for mortality [ [7] , [8] , [9] , [10] , [11] ].…”

Section: Introductionmentioning

confidence: 54%

Exposure to sulfur mustard increases the risk for mortality in patients with COVID-19 infection: A cohort study

Kolivand¹,

Fathi

Kheyrati

et al. 2022

The American Journal of Emergency Medicine

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Objective This study aims to assess the prognosis of inpatients with COVID-19 infection who have a history of sulfur mustard exposure. Methods We started a cohort study in October 2020 and ended in May 2021 on inpatients with COVID-19 infection who had been admitted to university healthcare centers. The analytic sample included 960 inpatients having COVID-19 infection (192 with; and 768 without sulfur mustard exposure). The exposed patients were male war veterans, and the unexposed patients were male individually age-matched people. All patients had a positive RT-PCR test and a positive chest CT for COVID-19. The outcome was death within 28 days of admission, and the predictors were clinical features recorded at patients' bedsides. Results There was a significantly higher prevalence for asthma ( p = 0.026) and pulmonary disease other than asthma ( p < 0.001) in patients with the exposure. Sulfur mustard exposure was associated with increased risk for mortality of COVID-19 [hazard ratio (95% CI) = 1.92 (1.14,3.24), p = 0.013]. Early intubation signified a poor prognosis [hazard = 7.34 (4.65,11.58), p < 0.001]. However, individuals with higher PaO2 [hazard = 0.97 (0.95,0.98), p < 0.001], or people undergoing O2 therapy early upon admission [hazard = 0.58 (0.38,0.89), p = 0.011] showed lower risks for mortality. Individuals with asthma were at higher risk for mortality [hazard = 3.76 (1.69,8.36), p = 0.001]. Conclusion Individuals with COVID-19 infection and sulfur mustard exposure should be considered high-risk patients and that, healthcare settings should be ready to provide critical care for them, including O 2 therapy. They are more likely to have asthma or other pulmonary diseases.

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Sex Differences in Coronavirus Disease 2019 (COVID-19) Hospitalization and Mortality

Cited by 86 publications

References 29 publications

Disparities in COVID-19 Fatalities among Working Californians

Disparities in COVID-19 Fatalities among Working Californians

National Population-Level Disparities in COVID-19 Mortality Across the Intersection of Race/Ethnicity and Sex in the United States

Exposure to sulfur mustard increases the risk for mortality in patients with COVID-19 infection: A cohort study

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