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1.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328814

ABSTRACT

Introduction: Several international studies have reported sex differences in COVID-19 mortality. The Dutch healthcare system is characterized by as strong focus on primary care and active patient participation in medical choices, such as invasive therapies. This study aims at identifying potential sex-specific predictors of in-hospital mortality and non-ICU policy in patients with COVID-19. Methods: : In this observational cohort study, we included participants hospitalized with COVID-19 during the first wave (March-May 2020) of the pandemic in six regional hospitals in the Netherlands. We computed descriptive statistics and logistic regression models using sex-disaggregated data to identify predictors of in-hospital mortality. Followingly, we analyzed the clinical features of female and male COVID-19 patients who had a non-ICU policy. Results: : We included 1262 patients (63.7% men) in this study. Higher age, higher LDH level, lower diastolic blood pressure, and lower peripheral oxygen saturation were associated with in-hospital mortality in female and male patients. Shorter symptom duration before admission and more comorbidities associated with in-hospital mortality only in female patients. 33.8% of the female and 30.6% of the male patients had a non-ICU policy. We identified a significant rise in this policy in female patients over the course of the first wave compared to males, which could not be explained solely by age and clinical differences. Discussion: Potential sex differences in symptom development and the sex-specific impact of immune dysfunction on COVID-19 prognosis need further evaluation. Sex differences in ICU care preferences of these patients should be examined to identify underlying gender-related patterns.

2.
J Womens Health (Larchmt) ; 30(12): 1686-1692, 2021 12.
Article in English | MEDLINE | ID: covidwho-1591509

ABSTRACT

Background: Although sex differences are described in Coronavirus Disease 2019 (COVID-19) diagnoses and testing, many studies neglect possible gender-related influences. Additionally, research is often performed in clinical populations, while most COVID-19 patients are not hospitalized. Therefore, we investigated associations between sex and gender-related variables, and COVID-19 diagnoses and testing practices in a large general population cohort during the first wave of the pandemic when testing capacity was limited. Methods: We used data from the Lifelines COVID-19 Cohort (N = 74,722; 60.8% female). We applied bivariate and multiple logistic regression analyses. The outcomes were a COVID-19 diagnosis (confirmed by SARS-CoV-2 PCR testing or physician's clinical diagnosis) and PCR testing. Independent variables included among others participants' sex, age, somatic comorbidities, occupation, and smoking status. Sex-by-comorbidity and sex-by-occupation interaction terms were included to investigate sex differences in associations between the presence of comorbidities or an occupation with COVID-19 diagnoses or testing practices. Results: In bivariate analyses female sex was significantly associated with COVID-19 diagnoses and testing, but significance did not persist in multiple logistic regression analyses. However, a gender-related variable, being a health care worker, was significantly associated with COVID-19 diagnoses (OR = 1.68; 95%CI = 1.30-2.17) and testing (OR = 12.5; 95%CI = 8.55-18.3). Female health care workers were less often diagnosed and tested than male health care workers (ORinteraction = 0.54; 95%CI = 0.32-0.92, ORinteraction = 0.53; 95%CI = 0.29-0.97, respectively). Conclusions: We found no sex differences in COVID-19 diagnoses and testing in the general population. Among health care workers, a male preponderance in COVID-19 diagnoses and testing was observed. This could be explained by more pronounced COVID-19 symptoms in males or by gender inequities.


Subject(s)
COVID-19 , COVID-19 Testing , Cohort Studies , Female , Humans , Male , Pandemics , SARS-CoV-2 , Sex Characteristics
3.
Nat Commun ; 12(1): 4015, 2021 07 06.
Article in English | MEDLINE | ID: covidwho-1298840

ABSTRACT

Sex and gender differences impact the incidence of SARS-CoV-2 infection and COVID-19 mortality. Furthermore, sex differences influence the frequency and severity of pharmacological side effects. A large number of clinical trials to develop new therapeutic approaches and vaccines for COVID-19 are ongoing. We investigated the inclusion of sex and/or gender in COVID-19 studies on ClinicalTrials.gov, collecting data for the period January 1, 2020 to January 26, 2021. Here, we show that of the 4,420 registered SARS-CoV-2/COVID-19 studies, 935 (21.2%) address sex/gender solely in the context of recruitment, 237 (5.4%) plan sex-matched or representative samples or emphasized sex/gender reporting, and only 178 (4%) explicitly report a plan to include sex/gender as an analytical variable. Just eight (17.8%) of the 45 COVID-19 related clinical trials published in scientific journals until December 15, 2020 report sex-disaggregated results or subgroup analyses.


Subject(s)
COVID-19/therapy , Clinical Studies as Topic/statistics & numerical data , COVID-19/epidemiology , Female , Humans , Male , Patient Selection , SARS-CoV-2 , Sex Factors
4.
BMC Health Serv Res ; 21(1): 624, 2021 Jun 30.
Article in English | MEDLINE | ID: covidwho-1286822

ABSTRACT

BACKGROUND: The COVID-19 pandemic and lockdown evoked great worries among professionals in the field of domestic violence and abuse (DVA) as they expected a rise of the phenomenon. While many countries reported increased DVA, the Netherlands did not. To understand this discrepancy and the overall impact of the lockdown on DVA support services, we interviewed DVA professionals about their experiences with DVA during the rise of COVID-19, the impact of the lockdown on clients and working conditions, and views on eHealth and online tools. METHODS: Semi-structured interviews were conducted among 16 DVA professionals with various specializations. This data was analyzed using open thematic coding and content analysis. RESULTS: Most professionals did not see an increase in DVA reports but they did notice more severe violence. They experienced less opportunities to detect DVA and worried about their clients' wellbeing and the quality of (online) care. Furthermore, their working conditions rapidly changed, with working from home and online, and they expressed frustration, insecurity and loneliness. Professionals feel eHealth and online tools are not always suitable but they do see them as an opportunity to increase reach and maintain services when physical contact is not possible. CONCLUSION: This study suggests DVA was probably under-detected during the lockdown rather than not having increased. The Dutch system heavily relies on professionals to detect and report DVA, suggesting a need for critical evaluation of the accessibility of professional help. Professionals experienced significant challenges and should themselves be supported psychologically and in their changed work practices to maintain their ability to aid survivors.


Subject(s)
COVID-19 , Domestic Violence , Communicable Disease Control , Humans , Netherlands , Pandemics , SARS-CoV-2
8.
Eur Cardiol ; 15: e62, 2020 Feb.
Article in English | MEDLINE | ID: covidwho-782530

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) pandemic has revealed important differences between the sexes in epidemiology, risk factors, clinical course, mortality and socioeconomic dimensions of the disease in all populations worldwide. This has emphasised the need for a better understanding of diversity aspects in healthcare to improve prevention, treatment and long-term consequences. In this article, the authors describe the most relevant knowledge thus far on sex differences regarding COVID-19.

9.
Int J Environ Res Public Health ; 17(10)2020 05 25.
Article in English | MEDLINE | ID: covidwho-361436

ABSTRACT

The COVID-19 global pandemic is accelerating investigations for effective vaccines and repurposable validated therapeutics [...].

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