Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: A retrospective study of 168 severe patients
Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: A retrospective study of 168 severe patients
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DOI：
10.1371/journal.ppat.1008520
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发表时间：
2020-04-01
期刊：
影响因子：
6.7
通讯作者：
Wu, Peng
中科院分区：
文献类型：
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作者：
Meng, Yifan;Wu, Ping;Wu, Peng
作者总结总体而言，我们的结果突出了COVID-19临床特征和预后的性别特异性差异，这与其他COVID-19相关研究中观察到的性别偏见一致。我们还提供了更多的证据，并探讨了流行病学分析的潜在机制。六个具有显著性别差异的候选实验室指标被认为是影响COVID-19预后的潜在介质。COVID-19的年龄特异性风险分布显示预后与年龄/合并症之间呈正相关，性别对预后有显著影响。我们还强调，性别是一个生物变量，在COVID-19的预防和治疗中应予以考虑。我们希望这些方法可以作为指导临床医生提供及时和具体的治疗。显然，未来的研究有必要阐明女性和男性之间不同的途径和细胞反应。关键的挑战是如何最好地利用这种差异为男性和女性提供充分的保护。在重症患者中，确认性别与冠状病毒疾病-19（COVID-19）进展之间的关系及其潜在机制。在这项回顾性研究中，我们纳入了168名连续重症患者，这些患者于2020年1月16日至2月4日期间在中国武汉同济医院住院，病原体确诊为COVID-19。对男性和女性的临床特征、实验室参数和结局进行比较和分析。在本研究中，我们分析了168例COVID-19重症患者，其中男性86例，女性82例，48例（28.6%）被诊断为危重患者。86例男性患者中，12.8%（11/86）死亡，75.6%（65/86）出院; 82例女性患者中，7.3%（6/82）死亡，86.6%（71/82）出院。11项实验室参数显示男性和女性患者之间存在显著差异，其中6项在整个临床过程中死亡患者高于出院患者。在校正的Logistic回归分析中，有合并症的男性比没有合并症的男性表现出更高的危重病风险（OR = 3.824，95%CI = 1.279-11.435）。然而，这种关联在女性患者中减弱为零（OR = 2.992，95%CI = 0.937-9.558）。在年龄和危重病病情之间的关系中观察到类似的性别特异性趋势。我们强调了临床特征和预后的性别特异性差异。男性患者似乎更容易受到年龄和合并症的影响。性别是预防和治疗COVID-19时应考虑的重要生物变量。
Author summaryOverall, our results highlight sex-specific differences in clinical characteristics and prognosis to COVID-19, which are consistent with the sex-bias observed in other COVID-19 related studies. We also provided more evidence and explored the underlying mechanism with epidemiological analysis. Six candidate laboratory indicators with significant sex differences were considered as potential mediators affecting the prognosis of COVID-19. The age-specific risk distributions of COVID-19 showed a positive correlation between the prognosis and age/ comorbidities, which was significantly affected by sex. We also emphasize that sex is a biological variable that should be considered in the prevention and therapy of COVID-19. It is our hope that these methods may serve as a guide to the clinician in providing timely and specific therapy. Obviously, future studies are warranted to elucidate the different pathways and cellular responses between women and men. The key challenge is how best to use this disparity for providing adequate protection in both males and females.To confirm the relationship between sex and the progression of Coronavirus Disease-19 (COVID-19), and its potential mechanism, among severe patients. For this retrospective study, we included 168 consecutive severe patients with pathogen-confirmed COVID-19 who were hospitalized between January 16th and February 4th, 2020, at Tongji Hospital in Wuhan, China. Clinical characteristics, laboratory parameters, and outcomes were compared and analyzed between males and females. In the present study, we analyzed 168 severe patients with COVID-19, including 86 males and 82 females, and 48 patients (28.6%) were diagnosed as critically ill. Of 86 male patients, 12.8% (11/86) died and 75.6% (65/86) were discharged; of 82 female patients, 7.3% (6/82) died and 86.6% (71/82) were discharged. Eleven laboratory parameters showed significant differences between male and female patients, and six of them were higher during the whole clinical course in patients who died than in patients who were discharged. In adjusted logistic regression analysis, males with comorbidities presented a higher risk of being critically ill than males without comorbidities (OR = 3.824, 95% CI = 1.279-11.435). However, this association attenuated to null in female patients (OR = 2.992, 95% CI = 0.937-9.558). A similar sex-specific trend was observed in the relation between age and critically ill conditions. We highlighted sex-specific differences in clinical characteristics and prognosis. Male patients appeared to be more susceptible to age and comorbidities. Sex is an important biological variable that should be considered in the prevention and treatment of COVID-19.