Gender-based disparities in COVID-19 patient outcomes
Gender-based disparities in COVID-19 patient outcomes
复制标题
DOI：
10.1136/jim-2020-001641
复制
发表时间：
2021-04-01
影响因子：
2.6
通讯作者：
Dodani, Sunita
中科院分区：
文献类型：
--
作者：
Marik, Paul Ellis;DePerrior, Sarah E.;Dodani, Sunita
到目前为止报道的研究表明，与女性相比，患有新冠肺炎的男性疾病更严重，预后更差。对这一发现的解释并不完全清楚。这项研究的目的是比较男性和女性的临床特征、炎症生物标志物和临床结果。这项回顾性研究包括2020年1月1日至2020年6月15日弗吉尼亚州10家医院收治的新冠肺炎患者。比较男性和女性的人口学数据、合并症和炎症标志物，包括C反应蛋白(CRP)、D-二聚体、铁蛋白和中性粒细胞/淋巴细胞比率，以及患者的预后。在研究期间，701名经聚合酶链式反应证实的新冠肺炎感染患者入院治疗。患者平均年龄61岁+/-17岁。男性370人(52.8%)。与女性患者相比，男性患者在年龄、种族分布和合并症方面没有差异。然而，男性的C反应蛋白和铁蛋白的基线和峰值水平均显著高于女性。虽然男女之间的基线D-二聚体相似，但男性的最大D-二聚体明显更高。男性有证据表明疾病更严重，进入重症监护病房的人数明显增加，医院死亡率也接近更高。我们的研究支持了新冠肺炎会导致男性更严重疾病的观察。男性的疾病严重程度更高并不是由于年龄或合并症的影响；然而，与实验研究一致，男性有证据表明炎症反应加剧，这可能是疾病严重程度的原因。
Studies reported to date suggest that men with COVID-19 have more severe disease and worse outcomes when compared with women. The explanation for this finding is not entirely clear. The goal of this study was to compare clinical characteristics, inflammatory biomarkers and clinical outcome between men and women. This retrospective study included patients with COVID-19 admitted to 10 Virginia hospitals from January 1, 2020, to June 15, 2020. Demographic data, comorbidities, and inflammatory markers, including C reactive protein (CRP), D-dimer, ferritin, and the neutrophil:lymphocyte ratio, as well as patient outcomes, were compared between men and women. During the study period, 701 patients with PCR-confirmed COVID-19 infection were admitted. The patient's mean age was 61 +/- 17 years. There were 370 men (52.8%). There was no difference in age, racial distribution, and comorbidities in the male patients compared with the female patients. However, both the baseline and peak levels of CRP and ferritin were significantly higher in men as compared with women. While the baseline D-dimer was similar between the sexes, men had a significantly higher maximal D-dimer. Men had evidence of greater disease severity, with a significantly greater admission to the intensive care unit and borderline higher hospital mortality. Our study supports the observation that COVID-19 causes more severe disease in men. The greater disease severity in men was not due to the effect of age or comorbidities; however, in keeping with experimental studies, men had evidence of a heightened inflammatory response, likely contributing to disease severity.