Gender Susceptibility to COVID-19 Mortality: Androgens as the Usual Suspects?

Identification of the causal risk factors of COVID-19 would allow better risk stratification and designing effective therapies. Epidemiological data have shown a higher incidence and mortality of COVID-19 in males compared to females. Here, we have used logistic regression analysis modeling to determine the association between gender and COVID-19 mortality in the Iranian population. The records of 2293 patients with COVID-19 infection were analyzed. The odds of death due to COVID-19 were 1.7 times higher in males compared to females after adjustment for age and background diseases. The gender difference was mainly observed at higher ages, suggesting an adjusted 2.32-fold higher risk of mortality in males aged >59.5 years old compared to females within the same age group. This finding suggests the male gender is a potential predisposing factor for mortality due to COVID-19 infection. The potential role of male hormones, particularly testosterone, as therapeutic targets deserves further investigation.

The Primary Outcomes and Epidemiological and Clinical Features of Coronavirus Disease 2019 (COVID-19) in Iran.

AIM: We aimed to describe the epidemiological and clinical characteristics of Iranian patients with COVID-19. METHODS: In this single-center and retrospective study, patients with confirmed COVID-19 infections were enrolled. Univariate and multivariate logistic regression methods were used to explore the risk factors associated with outcomes. RESULTS: Of 179 patients with confirmed COVID-19 infection, 12 remained hospitalized at the end of the study and 167 were included in the final analysis. Of these, 153 (91.6%) were discharged and 14 (8.38%) died in hospital. Approximately half (50.9%) of patients suffered from a comorbidity, with diabetes or coronary heart disease being the most common in 20 patients. The most common symptoms on admission were fever, dyspnea, and cough. The mean durations from first symptoms to hospital admission was 8.64 ± 4.14 days, whereas the mean hospitalization time to discharge or death was 5.19 ± 2.42 and 4.35 ± 2.70 days, respectively. There was a significantly higher age in non-survivor patients compared with survivor patients. Multivariate regression showed increasing odds ratio (OR) of in-hospital death associated with respiratory rates >20 breaths/min (OR: 5.14, 95% CI: 1.19-22.15, p = 0.028) and blood urea nitrogen (BUN) >19 mg/dL (OR: 4.54, 95% CI: 1.30-15.85, p = 0.017) on admission. In addition, higher respiratory rate was associated with continuous fever (OR: 4.08, 95% CI: 1.18-14.08, p = 0.026) and other clinical symptoms (OR: 3.52, 95% CI: 1.05-11.87, p = 0.04). CONCLUSION: The potential risk factors including high respiratory rate and BUN levels could help to identify COVID-19 patients with poor prognosis at an early stage in the Iranian population.