Sex Differences in COVID-19 Outcomes.

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the cause of an outbreak of severe acute respiratory syndrome in Wuhan City, China in December 2019. Since then, it has caused a worldwide pandemic with over six million deaths. Many studies have been published on coronavirus disease 2019 (COVID-19), but only a few have compared the outcomes of COVID-19 between males and females, especially in African countries and the Middle East. Studies published to date on this topic report that male patients infected with SARS-CoV-2 have worse outcomes than females. This study aimed to compare sex differences in COVID-19 outcomes in a tertiary care hospital in Casablanca (Morocco). Methodology We included all adult patients hospitalized for COVID-19 infection in Cheikh Khalifa Hospital. We categorized patients according to gender and analyzed the characteristics and outcomes of each group. Results In total, 134 patients with polymerase chain reaction (PCR)-confirmed COVID-19 were admitted during the study period. These included 72 (53.7%) men and 62 (46.4%) women. The median age of the patients was 53 years (interquartile range, IQR = 36-64). Men were significantly older than women (58 vs. 44) but there was no significant difference in comorbidities on comparing men and women. Values of median C-reactive protein (35 vs. 4), ferritin (326 vs. 72), and lactate dehydrogenase (264 vs. 208) were significantly higher in men. Lymphopenia was significantly more important in men (1.2 vs. 1.7), and the ratio of neutrophil/lymphocytes was significantly higher in men (3.37 vs. 1.84). Men had greater disease severity, with significantly higher intensive care unit admission (48.6% vs. 16.1%) and higher hospital mortality (18.1% vs. 1.6%). Conclusions COVID-19 gender disparities may be due to sex differences in the inflammatory response. These can be explained by the role of sex hormones and sex chromosomes on immune cells and their regulatory genes.

Infective endocarditis following COVID-19 pneumonia: about two cases.

Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and public health crisis across the world. The severity of this situation is escalating in certain populations, particularly when the COVID-19 diagnosis may delay the recognition of more dramatic illnesses such as infective endocarditis, which is a dreaded complication in patients with cardiac disease. We report the case of two patients who presented with infective endocarditis initially mistaken for COVID-19 pneumonia, which was responsible for a delay in diagnosis. We discuss the diagnostic difficulties as well as the management of this complication in the COVID-19 era. As a physician, one must remain alert to this dreaded complication, especially in patients with a cardiac history, in order to prevent it, detect it early, and manage it in time.

Acute Bilateral Renal Infarction: An Unusual Complication After Mitral Valve Replacement Surgery.

Bilateral renal infarction is an uncommon clinical condition that is frequently misdiagnosed. Its various mechanisms mainly include thrombotic and embolic. We report the case of a 51-year-old Moroccan woman, who presented with acute bilateral renal infarction three days following mitral valve replacement surgery of probable embolic origin despite curative heparin. Her renal function did not improve, and the patient developed chronic renal failure. Diagnosing bilateral renal infarction is challenging, especially in the postoperative period of mechanical mitral valve replacement surgery. Curative heparin therapy does not totally protect (100%) against this serious complication. This case study aimed to raise awareness of this rare clinical condition after cardiac surgery.