Sex differences in inflammatory markers in patients hospitalized with COVID-19 infection: Insights from the MGH COVID-19 patient registry.
Sex differences in inflammatory markers in patients hospitalized with COVID-19 infection: Insights from the MGH COVID-19 patient registry.
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DOI：
10.1371/journal.pone.0250774
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Ho JE
中科院分区：
文献类型：
--
作者：
Lau ES;McNeill JN;Paniagua SM;Liu EE;Wang JK;Bassett IV;Selvaggi CA;Lubitz SA;Foulkes AS;Ho JE
男性患新冠肺炎感染相关严重并发症的风险高于女性。女性更强大的免疫激活被认为有助于降低疾病的严重性，尽管全身炎症与新冠肺炎感染的更糟糕结局有关。目前尚不清楚全身炎症是否会导致新冠肺炎感染的性别差异。我们研究了2020年3月8日至4月27日在马萨诸塞州总医院住院的453名男性(平均年龄61岁)和328名女性(平均年龄62岁)新冠肺炎感染患者的炎症标志物的性别差异。采用多元线性回归模型检验性别与初始和高峰炎症标志物之间的关系。探索性分析采用多变量Logistic回归方法检验性和炎性标志物与28天临床结果的相关性。调整基线差异后，男性的初始和峰值C反应蛋白水平高于女性(初始C反应蛋白：0.29，SE0.07，P=0.0001；峰值C反应蛋白：BE0.31，SE0.07，P<；0.0001)，IL-6、PCT和铁蛋白的结果相似(均为P<；0.05)。与女性相比，男性死亡的几率大于1.5(OR 1.71，95%CI为1.04-2.80，p=0.03)。性别改变了峰值C反应蛋白与死亡和ICU入院的关系，男性比女性有更强的相关性(男性死亡：OR9.19，95%可信区间4.29-19.7，P<；0.0001；女性比2.81，95%可信区间1.52-5.18，P=0.009，P交互作用=0.02)。在781名因新冠肺炎感染住院的男性和女性样本中，男性表现出更强烈的炎症激活，其初始和峰值炎症标志物较高，以及较差的临床结果。更好地了解新冠肺炎感染免疫反应的性别差异，可能有助于揭示新冠肺炎感染的病理生理机制。
Men are at higher risk for serious complications related to COVID-19 infection than women. More robust immune activation in women has been proposed to contribute to decreased disease severity, although systemic inflammation has been associated with worse outcomes in COVID-19 infection. Whether systemic inflammation contributes to sex differences in COVID-19 infection is not known. We examined sex differences in inflammatory markers among 453 men (mean age 61) and 328 women (mean age 62) hospitalized with COVID-19 infection at the Massachusetts General Hospital from March 8 to April 27, 2020. Multivariable linear regression models were used to examine the association of sex with initial and peak inflammatory markers. Exploratory analyses examined the association of sex and inflammatory markers with 28-day clinical outcomes using multivariable logistic regression. Initial and peak CRP were higher in men compared with women after adjustment for baseline differences (initial CRP: ß 0.29, SE 0.07, p = 0.0001; peak CRP: ß 0.31, SE 0.07, p<0.0001) with similar findings for IL-6, PCT, and ferritin (p<0.05 for all). Men had greater than 1.5-greater odds of dying compared with women (OR 1.71, 95% CI 1.04–2.80, p = 0.03). Sex modified the association of peak CRP with both death and ICU admission, with stronger associations observed in men compared with women (death: OR 9.19, 95% CI 4.29–19.7, p <0.0001 in men vs OR 2.81, 95% CI 1.52–5.18, p = 0.009 in women, Pinteraction = 0.02). In a sample of 781 men and women hospitalized with COVID-19 infection, men exhibited more robust inflammatory activation as evidenced by higher initial and peak inflammatory markers, as well as worse clinical outcomes. Better understanding of sex differences in immune responses to COVID-19 infection may shed light on the pathophysiology of COVID-19 infection.
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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
DOI：
10.1073/pnas.1805268115
发表时间：
2018-12-04
影响因子：
11.1
作者：
Fink, Ashley L.;Engle, Kyrra;Klein, Sabra L.
通讯作者：
Klein, Sabra L.
影响因子：
39
作者：
Wu, Chaomin;Chen, Xiaoyan;Song, Yuanlin
通讯作者：
Song, Yuanlin
影响因子：
3.7
作者：
Bassett IV;Triant VA;Bunda BA;Selvaggi CA;Shinnick DJ;He W;Lu F;Porneala BC;Cao T;Lubitz SA;Meigs JB;Hsu J;Foulkes AS
通讯作者：
Foulkes AS
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