Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans
Abstract Objectives Determine if sex differences exist in clinical characteristics and outcomes of adults hospitalized for coronavirus disease 2019 (COVID-19) in a US healthcare system. Design Case series study. Setting and participants Sequentially hospitalized adults admitted for COVID-19 at two t...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-02-01
|
| Series: | Biology of Sex Differences |
| Online Access: | https://doi.org/10.1186/s13293-021-00359-2 |
| _version_ | 1818920276777238528 |
|---|---|
| author | Yilin Yoshida Scott A. Gillet Margo I. Brown Yuanhao Zu Sarah M. Wilson Sabreen J. Ahmed Saritha Tirumalasetty Dragana Lovre Marie Krousel-Wood Joshua L. Denson Franck Mauvais-Jarvis |
| author_facet | Yilin Yoshida Scott A. Gillet Margo I. Brown Yuanhao Zu Sarah M. Wilson Sabreen J. Ahmed Saritha Tirumalasetty Dragana Lovre Marie Krousel-Wood Joshua L. Denson Franck Mauvais-Jarvis |
| author_sort | Yilin Yoshida |
| collection | DOAJ |
| description | Abstract Objectives Determine if sex differences exist in clinical characteristics and outcomes of adults hospitalized for coronavirus disease 2019 (COVID-19) in a US healthcare system. Design Case series study. Setting and participants Sequentially hospitalized adults admitted for COVID-19 at two tertiary care academic hospitals in New Orleans, LA, between 27 February and 15 July 2020. Measures and outcomes Measures included demographics, comorbidities, presenting symptoms, and laboratory results. Outcomes included intensive care unit admission (ICU), invasive mechanical ventilation (IMV), and in-hospital death. Results We included 776 patients (median age 60.5 years; 61.4% women, 75% non-Hispanic Black). Rates of ICU, IMV, and death were similar in both sexes. In women versus men, obesity (63.8 vs 41.6%, P < 0.0001), hypertension (77.6 vs 70.1%, P = 0.02), diabetes (38.2 vs 31.8%, P = 0.06), chronic obstructive pulmonary disease (COPD, 22.1 vs 15.1%, P = 0.015), and asthma (14.3 vs 6.9%, P = 0.001) were more prevalent. More women exhibited dyspnea (61.2 vs 53.7%, P = 0.04), fatigue (35.7 vs 28.5%, P = 0.03), and digestive symptoms (39.3 vs 32.8%, P = 0.06) than men. Obesity was associated with IMV at a lower BMI (> 35) in women, but the magnitude of the effect of morbid obesity (BMI ≥ 40) was similar in both sexes. COPD was associated with ICU (adjusted OR (aOR), 2.6; 95%CI, 1.5–4.3) and IMV (aOR, 1.8; 95%CI, 1.2–3.1) in women only. Diabetes (aOR, 2.6; 95%CI, 1.2–2.9), chronic kidney disease (aOR, 2.2; 95%CI, 1.3–5.2), elevated neutrophil-to-lymphocyte ratio (aOR, 2.5; 95%CI, 1.4–4.3), and elevated ferritin (aOR, 3.6; 95%CI, 1.7–7.3) were independent predictors of death in women only. In contrast, elevated D-dimer was an independent predictor of ICU (aOR, 7.3; 95%CI, 2.7–19.5), IMV (aOR, 6.5; 95%CI, 2.1–20.4), and death (aOR, 4.5; 95%CI, 1.2–16.4) in men only. Conclusions This study highlights sex disparities in clinical determinants of severe outcomes in COVID-19 patients that may inform management and prevention strategies to ensure gender equity. |
| first_indexed | 2024-12-20T01:19:11Z |
| format | Article |
| id | doaj.art-c9b02b3dad664d578b1f428398a6e0d7 |
| institution | Directory Open Access Journal |
| issn | 2042-6410 |
| language | English |
| last_indexed | 2024-12-20T01:19:11Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Biology of Sex Differences |
| spelling | doaj.art-c9b02b3dad664d578b1f428398a6e0d72022-12-21T19:58:29ZengBMCBiology of Sex Differences2042-64102021-02-0112111110.1186/s13293-021-00359-2Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New OrleansYilin Yoshida0Scott A. Gillet1Margo I. Brown2Yuanhao Zu3Sarah M. Wilson4Sabreen J. Ahmed5Saritha Tirumalasetty6Dragana Lovre7Marie Krousel-Wood8Joshua L. Denson9Franck Mauvais-Jarvis10Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of MedicineDeming Department of Medicine, Tulane University School of MedicineDeming Department of Medicine, Tulane University School of MedicineDepartment of Biostatistics and Data Science, Tulane University School of Public Health and Tropical MedicineSection of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of MedicineSection of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of MedicineSection of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of MedicineSection of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of MedicineDeming Department of Medicine, Tulane University School of MedicineSection of Pulmonary Diseases, Critical Care, and Environmental Medicine, Deming Department of Medicine Tulane University School of MedicineSection of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of MedicineAbstract Objectives Determine if sex differences exist in clinical characteristics and outcomes of adults hospitalized for coronavirus disease 2019 (COVID-19) in a US healthcare system. Design Case series study. Setting and participants Sequentially hospitalized adults admitted for COVID-19 at two tertiary care academic hospitals in New Orleans, LA, between 27 February and 15 July 2020. Measures and outcomes Measures included demographics, comorbidities, presenting symptoms, and laboratory results. Outcomes included intensive care unit admission (ICU), invasive mechanical ventilation (IMV), and in-hospital death. Results We included 776 patients (median age 60.5 years; 61.4% women, 75% non-Hispanic Black). Rates of ICU, IMV, and death were similar in both sexes. In women versus men, obesity (63.8 vs 41.6%, P < 0.0001), hypertension (77.6 vs 70.1%, P = 0.02), diabetes (38.2 vs 31.8%, P = 0.06), chronic obstructive pulmonary disease (COPD, 22.1 vs 15.1%, P = 0.015), and asthma (14.3 vs 6.9%, P = 0.001) were more prevalent. More women exhibited dyspnea (61.2 vs 53.7%, P = 0.04), fatigue (35.7 vs 28.5%, P = 0.03), and digestive symptoms (39.3 vs 32.8%, P = 0.06) than men. Obesity was associated with IMV at a lower BMI (> 35) in women, but the magnitude of the effect of morbid obesity (BMI ≥ 40) was similar in both sexes. COPD was associated with ICU (adjusted OR (aOR), 2.6; 95%CI, 1.5–4.3) and IMV (aOR, 1.8; 95%CI, 1.2–3.1) in women only. Diabetes (aOR, 2.6; 95%CI, 1.2–2.9), chronic kidney disease (aOR, 2.2; 95%CI, 1.3–5.2), elevated neutrophil-to-lymphocyte ratio (aOR, 2.5; 95%CI, 1.4–4.3), and elevated ferritin (aOR, 3.6; 95%CI, 1.7–7.3) were independent predictors of death in women only. In contrast, elevated D-dimer was an independent predictor of ICU (aOR, 7.3; 95%CI, 2.7–19.5), IMV (aOR, 6.5; 95%CI, 2.1–20.4), and death (aOR, 4.5; 95%CI, 1.2–16.4) in men only. Conclusions This study highlights sex disparities in clinical determinants of severe outcomes in COVID-19 patients that may inform management and prevention strategies to ensure gender equity.https://doi.org/10.1186/s13293-021-00359-2 |
| spellingShingle | Yilin Yoshida Scott A. Gillet Margo I. Brown Yuanhao Zu Sarah M. Wilson Sabreen J. Ahmed Saritha Tirumalasetty Dragana Lovre Marie Krousel-Wood Joshua L. Denson Franck Mauvais-Jarvis Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans Biology of Sex Differences |
| title | Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans |
| title_full | Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans |
| title_fullStr | Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans |
| title_full_unstemmed | Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans |
| title_short | Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans |
| title_sort | clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in new orleans |
| url | https://doi.org/10.1186/s13293-021-00359-2 |
| work_keys_str_mv | AT yilinyoshida clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT scottagillet clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT margoibrown clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT yuanhaozu clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT sarahmwilson clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT sabreenjahmed clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT sarithatirumalasetty clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT draganalovre clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT mariekrouselwood clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT joshualdenson clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans AT franckmauvaisjarvis clinicalcharacteristicsandoutcomesinwomenandmenhospitalizedforcoronavirusdisease2019inneworleans |