Analysis of sex-specific risk factors and clinical outcomes in COVID-19.
Analysis of sex-specific risk factors and clinical outcomes in COVID-19.
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DOI：
10.1038/s43856-021-00006-2
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Huang, Kuan-lin
中科院分区：
文献类型：
--
作者：
Jun, Tomi;Nirenberg, Sharon;Weinberger, Tziopora;Sharma, Navya;Pujadas, Elisabet;Cordon-Cardo, Carlos;Kovatch, Patricia;Huang, Kuan-lin
性别一直被证明会影响COVID-19死亡率，但目前尚不清楚风险因素如何影响每种性别的临床结果。我们研究了纽约市一个医疗系统中从大流行开始至2020年8月5日因COVID-19住院的4930名患者的主要队列，以及2020年8月5日至2021年1月13日在同一医疗系统中因COVID-19住院的1645名患者的验证队列。在此，我们发现，在调整人口统计学和合并症后，男性与住院死亡率、插管和ICU护理独立相关。使用交互作用分析和性别分层模型，我们发现缺氧与性别相互作用优先增加女性的死亡风险，而肥胖与性别相互作用优先增加女性的插管和重症监护风险。在验证队列中，我们观察到男性仍然是死亡率的独立风险因素，但性别特异性相互作用没有重复。我们对一个大型COVID-19住院患者队列进行了全面的性别分层分析，突出了可能导致COVID-19结局性别差异的临床因素。男性死于COVID-19的风险高于女性，但其根本原因尚不完全清楚。我们检查了纽约市因COVID-19住院的男性和女性的医疗数据，以确定是否存在增加死亡风险或需要重症监护的因素。我们观察到，当考虑到其他因素时，因COVID-19住院的男性死亡风险高于女性。一些情况，如低氧水平和肥胖，似乎与大流行早期女性比男性更糟糕的结果有关，但需要进一步的研究来证实。这些发现强调了可能面临严重COVID-19风险增加的男性和女性群体。Jun等人评估了纽约因COVID-19住院的两个队列患者的性别分层临床结局。虽然男性性风险是两个队列中不良结局的风险因素-一个来自大流行早期，一个来自大流行后期-但最初观察到的一些性别特异性风险因素后来没有观察到。
Sex has consistently been shown to affect COVID-19 mortality, but it remains unclear how each sex’s clinical outcome may be distinctively shaped by risk factors. We studied a primary cohort of 4930 patients hospitalized with COVID-19 in a single healthcare system in New York City from the start of the pandemic till August 5, 2020, and a validation cohort of 1645 patients hospitalized with COVID-19 in the same healthcare system from August 5, 2020, to January 13, 2021. Here we show that male sex was independently associated with in-hospital mortality, intubation, and ICU care after adjusting for demographics and comorbidities. Using interaction analysis and sex-stratified models, we found that hypoxia interacted with sex to preferentially increase women’s mortality risk while obesity interacted with sex to preferentially increase women’s risk of intubation and intensive care in our primary cohort. In the validation cohort, we observed that male sex remained an independent risk factor for mortality, but sex-specific interactions were not replicated. We conducted a comprehensive sex-stratified analysis of a large cohort of hospitalized COVID-19 patients, highlighting clinical factors that may contribute to sex differences in the outcome of COVID-19. Men are at higher risk of death from COVID-19 than women, but the underlying reasons are not fully understood. We examined the medical data of men and women hospitalized with COVID-19 in New York City to determine whether there were factors which raised the risk of death or requiring intensive care more for one sex rather than the other. We observed that men hospitalized with COVID-19 had a higher risk of death than women when other factors taken into account. Some conditions, like low oxygen levels and obesity, appeared to be associated with worse outcomes in women compared to men early in the pandemic but further studies will be necessary for confirmation. These findings highlight groups of men and women who may be at increased risk of severe COVID-19. Jun et al. evaluate sex-stratified clinical outcomes in two cohorts of patients hospitalized with COVID-19 in New York. While male sex risk is a risk factor for poor outcome in both cohorts – one from earlier and one from later on in the pandemic – some of the sex-specific risk factors observed initially are not observed later on.
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DOI：
10.1126/science.abd4585
发表时间：
2020-10-23
期刊：
Science (New York, N.Y.)
影响因子：
--
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Casanova JL
影响因子：
24.3
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He, Jian-xing
影响因子：
4
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影响因子：
82.9
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通讯作者：
Gnjatic S
DOI：
10.1016/s1473-3099(10)70049-9
发表时间：
2010-05
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Klein SL;Jedlicka A;Pekosz A
通讯作者：
Pekosz A