Gender differences in patients hospitalized for COVID-19 disease

ABSTRACT

Background and Aim: The aim of this study is to evaluate gender differences in patients hospitalized for COVID-19 in terms of symptoms, laboratory data and disease outcomes, and to identify variables capable of increasing the risk of critical illness and lethality. Methods: Prospective observational study in the COVID wards of the ASST Fatebenefratelli-Sacco (MI), during the first wave of the pandemic. All COVID patients were included. A descriptive analysis was carried out to assess the relationship between several variables and gender, and a multivariate analysis to establish the association of the variables analyzed with disease severity and in-hospital mortality. The probability of survival at 30 days was evaluated by Kaplan-Meier curves. Results: 520 patients, 67% male and 33% female, were recruited. Of males, 30.1% presented with critical conditions at hospitalization, 18.7% in females. Mortality was 24.6% among males and 15.8% in females. Criticality at onset was associated with high CRP, elevated LDH, increase of days from onset of symptoms. Mortality during hospitalization was associated with age, obesity, critical conditions at admission, some laboratory analytes (decreased haemoglobin, elevated D-dimer, elevated LDH, reduced eGFR, elevated CK). The 30-day survival probability was 88% for women and 77% for men. Conclusions: Females are more protected against SARS-CoV-2 infection, have a better clinical and laboratory profile and subject to less lethality. Males are more hospitalized and more at risk of developing severe and lethal forms of the disease.