Association Between Sex Hormone Levels and Clinical Outcomes in Patients With COVID-19 Admitted to Hospital: An Observational, Retrospective, Cohort Study

Beltrame, Anna; Salguero, Pedro; Rossi, Emanuela; Conesa, Ana; Moro, Lucía; Bettini, Laura Rachele; Rizzi, Eleonora; D’Angiò, Mariella; Deiana, Michela; Piubelli, Chiara; Rebora, Paola; Duranti, Silvia; Bonfanti, Paolo; Capua, Ilaria; Tarazona, Sonia; Valsecchi, Maria Grazia

doi:10.3389/fimmu.2022.834851

Cited by 30 publications

(26 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Currently, there are data, divided by sex, on the incidence of long-COVID-19 only in the adult population. Quite interestingly, long-COVID-19 appears to be more probable in women than in men [46] in contrast to severe acute COVID-19 [47,48], independent of the severity of the original infection. Other risk factors for having long-COVID-19 seem to be a higher body mass index and older age [49][50][51].…”

Section: Discussionmentioning

confidence: 93%

Serum NGF and BDNF in Long-COVID-19 Adolescents: A Pilot Study

et al. 2022

View full text Add to dashboard Cite

COVID-19 (COronaVIrus Disease 19) is an infectious disease also known as an acute respiratory syndrome caused by the SARS-CoV-2. Although in children and adolescents SARS-CoV-2 infection produces mostly mild or moderate symptoms, in a certain percentage of recovered young people a condition of malaise, defined as long-COVID-19, remains. To date, the risk factors for the development of long-COVID-19 are not completely elucidated. Neurotrophins such as NGF (Nerve Growth Factor) and BDNF (Brain-Derived Neurotrophic Factor) are known to regulate not only neuronal growth, survival and plasticity, but also to influence cardiovascular, immune, and endocrine systems in physiological and/or pathological conditions; to date only a few papers have discussed their potential role in COVID-19. In the present pilot study, we aimed to identify NGF and BDNF changes in the serum of a small cohort of male and female adolescents that contracted the infection during the second wave of the pandemic (between September and October 2020), notably in the absence of available vaccines. Blood withdrawal was carried out when the recruited adolescents tested negative for the SARS-CoV-2 (“post-infected COVID-19”), 30 to 35 days after the last molecular test. According to their COVID-19 related outcomes, the recruited individuals were divided into three groups: asymptomatics, acute symptomatics and symptomatics that over time developed long-COVID-19 symptoms (“future long-COVID-19”). As a control group, we analyzed the serum of age-matched healthy controls that did not contract the infection. Inflammatory biomarkers (TNF-α, TGF-β), MCP-1, IL-1α, IL-2, IL-6, IL-10, IL-12) were also analyzed with the free oxygen radicals’ presence as an oxidative stress index. We showed that NGF serum content was lower in post-infected-COVID-19 individuals when compared to healthy controls; BDNF levels were found to be higher compared to healthy individuals only in post-infected-COVID-19 symptomatic and future long-COVID-19 girls, leaving the BDNF levels unchanged in asymptomatic individuals if compared to controls. Oxidative stress and inflammatory biomarkers were unchanged in male and female adolescents, except for TGF-β that, similarly to BDNF, was higher in post-infected-COVID-19 symptomatic and future long-COVID-19 girls. We predicted that NGF and/or BDNF could be used as early biomarkers of COVID-19 morbidity in adolescents.

show abstract

Section: Discussionmentioning

confidence: 93%

Serum NGF and BDNF in Long-COVID-19 Adolescents: A Pilot Study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Knowledge of sex differences is an essential ingredient in developing precision medicine ( 7 ). It has been found that sex could affect the manifestation and pathophysiology of many diseases ( 9 – 11 ). The impact of sex on outcomes in patients with sepsis has been widely investigated, yielding conflicting results ( 35 – 38 ).…”

Section: Discussionmentioning

confidence: 99%

“…A large retrospective study of 261,255 critically ill patients revealed that women less than 50 years of age had lower adjusted mortality than men ( 8 ). Moreover, different disease processes and outcomes between men and women were also found in some specific disease groups, like coronary artery disease ( 9 ), acute ischemic stroke ( 10 ) and coronavirus disease 2019 ( 11 ). This may be associated with the influence of sex hormones on the modulation of inflammation during immune responses ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

No sex differences in the incidence, risk factors and clinical impact of acute kidney injury in critically ill patients with sepsis

Peng

Tang

et al. 2022

Front. Immunol.

View full text Add to dashboard Cite

BackgroundSex-stratified medicine is an important aspect of precision medicine. We aimed to compare the incidence and risk factors of acute kidney injury (AKI) for critically ill men and women with sepsis. Furthermore, the short-term mortality was compared between men and women with sepsis associated acute kidney injury (SA-AKI).MethodThis was a retrospective study based on the Medical Information Mart for Intensive Care IV database. We used the multivariable logistic regression analysis to evaluate the independent effect of sex on the incidence of SA-AKI. We further applied three machine learning methods (decision tree, random forest and extreme gradient boosting) to screen for the risk factors associated with SA-AKI in the total, men and women groups. We finally compared the intensive care unit (ICU) and hospital mortality between men and women with SA-AKI using propensity score matching.ResultsA total of 6463 patients were included in our study, including 3673 men and 2790 women. The incidence of SA-AKI was 83.8% for men and 82.1% for women. After adjustment for confounders, no significant association was observed between sex and the incidence of SA-AKI (odds ratio (OR), 1.137; 95% confidence interval (CI), 0.949-1.361; p=0.163). The machine learning results revealed that body mass index, Oxford Acute Severity of Illness Score, diuretic, Acute Physiology Score III and age were the most important risk factors of SA-AKI, irrespective of sex. After propensity score matching, men had similar ICU and hospital mortality to women.ConclusionsThe incidence and associated risk factors of SA-AKI are similar between men and women, and men and women with SA-AKI experience comparable rates of ICU and hospital mortality. Therefore, sex-related effects may play a minor role in developing SA-AKI. Our study helps to contribute to the knowledge gap between sex and SA-AKI.

show abstract

“…For example, low testosterone levels that can be seen in older men have been associated with immunological changes that can lead to an increased likelihood of infection [ 9 ]. More specifically, low testosterone has been associated with a higher likelihood of severe COVID-19 pneumonia [ 18 , 19 , 20 , 21 ]. Additionally, mucociliary clearance in the respiratory tract is reduced in older individuals, as has been shown in a study among healthy volunteers of different ages in whom mucociliary clearance and ciliary beat frequency were calculated and were found to be lower in older individuals [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in Older Individuals Requiring Hospitalization

Ιωάννου

Spentzouri²,

Konidaki³

et al. 2022

Infectious Disease Reports

View full text Add to dashboard Cite

Older individuals have an increased risk for severe coronavirus disease 2019 (COVID-19) and a higher risk for complications and death. The aim of this study was to investigate the clinical characteristics of older patients admitted with COVID-19 and describe their outcomes. This was a retrospective cohort study of patients older than 65 years admitted to the COVID-19 Department of the University Hospital of Heraklion. Data recorded and evaluated included age, gender, Infectious Diseases Society of America (IDSA) severity score, Charlson comorbidity index (CCI), high-flow nasal oxygen (HFNO) use, admission to the Intensive Care Unit (ICU), laboratory exams, treatment administered, and outcome. In total, 224 patients were evaluated in the present study. The median age was 75 years and 105 (46.9%) were female. In 50 patients (22.7%), HFNO was used and 23 (10.3%) were admitted to the ICU. Mortality was 13.4% (30 patients). Patients that died had higher age, were more likely to be male, had an IDSA severity score of 3, had prior HFNO use, had been admitted to the ICU, and were also more likely to have a higher white blood cell (WBC) count, CRP, ferritin, procalcitonin, d-dimers, and troponin. A multivariate logistic regression analysis identified age and the need for HFNO use to be independently positively associated with mortality. To conclude, COVID-19 carries significant mortality in hospitalized older patients, which increases with age, while the need for HFNO also increased the likelihood of worse outcomes. Clinicians caring for patients with COVID-19 should bear in mind these two factors. Future studies could elaborate on the effect of new variants on the dynamics of mortality in older patients.

show abstract

Association Between Sex Hormone Levels and Clinical Outcomes in Patients With COVID-19 Admitted to Hospital: An Observational, Retrospective, Cohort Study

Cited by 30 publications

References 30 publications

Serum NGF and BDNF in Long-COVID-19 Adolescents: A Pilot Study

Serum NGF and BDNF in Long-COVID-19 Adolescents: A Pilot Study

No sex differences in the incidence, risk factors and clinical impact of acute kidney injury in critically ill patients with sepsis

COVID-19 in Older Individuals Requiring Hospitalization

Contact Info

Product

Resources

About