New research presented at this week’s ESCMID conference on coronavirus disease (ECCVID, online September 23-25) confirms that men with COVID-19 have worse outcomes than women, possibly related to higher levels of inflammation .
The study was conducted by Dr. Frank Hanses from the University Hospital Regensburg and colleagues and shows that after adjusting to various factors, men have a 62% increased risk of COVID-19-associated deaths compared to women. (see Figure 2 of the poster).
Increasing evidence suggests a gender-specific difference in SARS-CoV-2 infections. Men are overrepresented in most cohorts, and previously published data show a higher incidence of severe COVID-19 courses in men. In order to collect clinical data from the pandemic, the international multicenter Lean European Open Survey on the SARS-CoV-2 infected patient register (LEOSS) was set up.
The German Society for Infectious Diseases (DGI) sponsored this registry to provide scientists and physicians with reliable clinical data so they can answer numerous urgent questions, such as: B. When COVID-19 patients experience severe symptoms.
What is the best possible treatment? Which measures have been successful so far? As part of the new initiative, it is planned to make the collected data available to the scientific community for use in crowd-based analyzes.
In this study, the authors present an initial analysis of the LEOSS data set on the influence of gender on COVID-19. They retrospectively rated 3,129 adult patients with COVID-19 who were enrolled between March and July 2020. The basic characteristics include socio-demographic data and comorbidities according to the Charlson Comorbidity Index (number of pre-existing diseases) (CCI).
The clinical manifestation of COVID-19 has been described in four phases: uncomplicated (asymptomatic / mild symptoms), complicated (need for oxygen supplementation), critical (need for critical care), and recovery. Symptoms, vital functions, inflammation markers and therapeutic interventions were analyzed across all phases, as was the clinical result.
The male to female ratio in this mostly hospitalized cohort was 1.48, with men predominating in all age groups. The male dominance was even more pronounced in the age groups> 65 years and> 75 years.
The mean CCI and most comorbidities did not differ significantly between men and women, while coronary artery disease (18% versus 10%) and smoking rates were higher in male patients (14.5 versus 10.5%) than in female patients.
Progression to a critical phase (which generally reflects admission to the ICU) was observed more frequently in men than in women (30.6% versus 17.2%). The mean length of hospital stay was longer in male patients (15.4 vs. 13.3 days).
Both raw mortality (19.2% versus 12.9%) and mortality due to COVID-19 (17.1% versus 10.3%, Figure 1, e-poster) were significantly higher in men. Masculinity was found to be an independent risk factor for a 62% increased risk of COVID-19-associated death in an analysis adjusted for various factors.
While most of the laboratory parameters were comparable between male and female patients with COVID-19, men had significantly higher inflammation markers (IL-6, CRP, PCT, ferritin) in all phases of the disease.
Men are more likely to reach critical stages of COVID-19. Men have higher mortality rates, as well as more frequent ICU admissions and longer hospital stays, all of which are associated with higher inflammatory parameters during all stages of COVID-19. In our cohort, this effect was not explained by differences in comorbidities, age or BMI between male and female patients. “
“We need more research on what exactly makes men more susceptible to COVID-19,” concludes Dr. Hanses. “We do not yet know which biological or possibly social factors lead to these marked differences.”
European Society for Clinical Microbiology and Infectious Diseases