Sex and Gender Differences in Testing, Hospital Admission, Clinical Presentation, and Drivers of Severe Outcomes From COVID-19.
Sex and Gender Differences in Testing, Hospital Admission, Clinical Presentation, and Drivers of Severe Outcomes From COVID-19.
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DOI：
10.1093/ofid/ofab448
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发表时间：
2021-09
影响因子：
4.2
通讯作者：
Gupta A
中科院分区：
文献类型：
--
作者：
Scully EP;Schumock G;Fu M;Massaccesi G;Muschelli J;Betz J;Klein EY;West NE;Robinson M;Garibaldi BT;Bandeen-Roche K;Zeger S;Klein SL;Gupta A
与女性相比，男性患严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）的病情严重程度和死亡率更高，但男性易感性的机制尚不清楚。我们对马里兰州/华盛顿特区地区5家医院的SARS-CoV-2检测和入院数据进行了回顾性队列分析。使用年龄分层逻辑回归模型，我们量化了男性性别对严重疾病或死亡复合结局风险的影响（世界卫生组织评分为5-8），并测试了人口统计学、合并症、健康行为和实验室炎症标志物对性别效应的影响。在213 175例SARS-CoV-2检测中，尽管阳性率相似，但18至74岁年龄段的男性住院率更高。在2626例住院患者中，临床炎症标志物（白细胞介素-6、c反应蛋白、铁蛋白、绝对淋巴细胞计数和中性粒细胞与淋巴细胞之比）女性比男性更有利（P < 0.001）。在18 - 49岁的人群中，男性在早期（优势比[OR]， 3.01; 95% CI， 1.75至5.18）和住院期间疾病高峰期（OR, 2.58; 95% CI， 1.78至3.74）均有较高的严重结局风险。尽管在人口统计学、表现特征、合并症和健康行为方面存在多种差异，但这些变量并未改变男性与严重疾病的关联。只有临床炎症标志物值改变了性别效应，将18-49岁男性严重结局的OR降低到早期的1.81 （95% CI, 1.00 - 3.26）和疾病高峰时的1.39 （95% CI, 0.93 - 2.08）。较高的炎性实验室检测值与男性感染2019年严重冠状病毒病的风险增加有关。对SARS-CoV-2感染的性别特异性炎症反应可能是结果的性别差异的基础。
Males experience increased severity of illness and mortality from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with females, but the mechanisms of male susceptibility are unclear. We performed a retrospective cohort analysis of SARS-CoV-2 testing and admission data at 5 hospitals in the Maryland/Washington DC area. Using age-stratified logistic regression models, we quantified the impact of male sex on the risk of the composite outcome of severe disease or death (World Health Organization score 5–8) and tested the impact of demographics, comorbidities, health behaviors, and laboratory inflammatory markers on the sex effect. Among 213 175 SARS-CoV-2 tests, despite similar positivity rates, males in age strata between 18 and 74 years were more frequently hospitalized. For the 2626 hospitalized individuals, clinical inflammatory markers (interleukin-6, C-reactive protein, ferritin, absolute lymphocyte count, and neutrophil:lymphocyte ratio) were more favorable for females than males (P < .001). Among 18–49-year-olds, male sex carried a higher risk of severe outcomes, both early (odds ratio [OR], 3.01; 95% CI, 1.75 to 5.18) and at peak illness during hospitalization (OR, 2.58; 95% CI, 1.78 to 3.74). Despite multiple differences in demographics, presentation features, comorbidities, and health behaviors, these variables did not change the association of male sex with severe disease. Only clinical inflammatory marker values modified the sex effect, reducing the OR for severe outcomes in males aged 18–49 years to 1.81 (95% CI, 1.00 to 3.26) early and 1.39 (95% CI, 0.93 to 2.08) at peak illness. Higher inflammatory laboratory test values were associated with increased risk of severe coronavirus disease 2019 for males. A sex-specific inflammatory response to SARS-CoV-2 infection may underlie the sex differences in outcomes.
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影响因子：
13.5
作者：
Grebely, Jason;Page, Kimberly;Sacks-Davis, Rachel;van der Loeff, Maarten Schim;Rice, Thomas M.;Bruneau, Julie;Morris, Meghan D.;Hajarizadeh, Behzad;Amin, Janaki;Cox, Andrea L.;Kim, Arthur Y.;McGovern, Barbara H.;Schinkel, Janke;George, Jacob;Shoukry, Naglaa H.;Lauer, Georg M.;Maher, Lisa;Lloyd, Andrew R.;Hellard, Margaret;Dore, Gregory J.;Prins, Maria
通讯作者：
Prins, Maria
DOI：
10.4049/jimmunol.1601896
发表时间：
2017-05-15
期刊：
Journal of immunology (Baltimore, Md. : 1950)
影响因子：
--
作者：
Channappanavar R;Fett C;Mack M;Ten Eyck PP;Meyerholz DK;Perlman S
通讯作者：
Perlman S
影响因子：
8.9
作者：
Alkhouli, Mohamad;Nanjundappa, Aravinda;Bhatt, Deepak L.
通讯作者：
Bhatt, Deepak L.
影响因子：
82.9
作者：
Del Valle DM;Kim-Schulze S;Huang HH;Beckmann ND;Nirenberg S;Wang B;Lavin Y;Swartz TH;Madduri D;Stock A;Marron TU;Xie H;Patel M;Tuballes K;Van Oekelen O;Rahman A;Kovatch P;Aberg JA;Schadt E;Jagannath S;Mazumdar M;Charney AW;Firpo-Betancourt A;Mendu DR;Jhang J;Reich D;Sigel K;Cordon-Cardo C;Feldmann M;Parekh S;Merad M;Gnjatic S
通讯作者：
Gnjatic S
影响因子：
3.7
作者：
Lau ES;McNeill JN;Paniagua SM;Liu EE;Wang JK;Bassett IV;Selvaggi CA;Lubitz SA;Foulkes AS;Ho JE
通讯作者：
Ho JE