Sex Differences in COVID-19 Hospitalization and Hospital Mortality among Patients with COPD in Spain: A Retrospective Cohort Study

Abstract

(1) Background: We aimed to assess the effect of COPD in the incidence of hospital admissions for COVID-19 and on the in-hospital mortality (IHM) according to sex. (2) Methods: We used national hospital discharge data to select persons aged ≥40 years admitted to a hospital with a diagnosis of COVID-19 in 2020 in Spain. (3) Results: The study population included 218,301 patients. Age-adjusted incidence rates of COVID-19 hospitalizations for men with and without COPD were 10.66 and 9.27 per 1000 persons, respectively (IRR 1.14; 95% CI 1.08–1.20; p < 0.001). The IHM was higher in men than in women regardless of the history of COPD. The COPD was associated with higher IHM among women (OR 1.09; 95% CI 1.01–1.22) but not among men. The COPD men had a 25% higher risk of dying in the hospital with COVID-19 than women with COPD (OR 1.25, 95% CI 1.1–1.42). (4) Conclusions: Sex differences seem to exist in the effect of COPD among patients suffering COVID-19. The history of COPD increased the risk of hospitalization among men but not among women, and COPD was only identified as a risk factor for IHM among women. In any case, we observed that COPD men had a higher mortality than COPD women. Understanding the mechanisms underlying these sex differences could help predict the patient outcomes and inform clinical decision making to facilitate early treatment and disposition decisions.

Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19

“…These data are consistent with a large body of literature that suggests that females are able to clear pathogens faster than males, potentially due to greater innate and adaptive immune responses to infections, including SARS-CoV-2 [ 38–42 ]. Whether these differences in SARS-CoV-2 clearance rates contribute to sex-based differences in COVID-19 outcomes that have been observed, including increased risk for COVID-19 hospitalization and mortality among men, is not known [ 43 , 44 ].…”

Can the ADO Index Be Used as a Predictor of Mortality from COVID-19 in Patients with COPD?

“…7,10 However, clinical and functional features associated with increased mortality risk among patients with COPD have been addressed in a few studies, and these studies have several limitations such as poor methodological design, data based on hospital records, insufficient evaluation of confounding factors, lack of data on pulmonary function tests, exacerbation history, and drug usage. [11][12][13] In this study, we included the COPET cohort of patients with COPD whose demographic and clinical characteristics were recorded face-to-face and in detail during their stable period. 14 We aimed to investigate the COVID-19 transmission status of the COPET cohort and their clinical, functional, prognostic and phenotypic features that may be associated with infection-related mortality during the pre-vaccination period.…”