Gender differences in patients with COVID-19: Focus on severity and mortality

Abstract

medRxiv preprint Key PointsQuestion: Are men more susceptible to getting and dying from Findings: In the case series, men tend to be more serious than women. In the public data set, the percentage of men were higher in the deceased group than in the survived group, although age was comparable between men and women.Meaning: Male gender is a risk factor for worse outcome in patients with COVID independent of age and susceptibility. AbstractImportance: The recent outbreak of Novel Coronavirus (SARS-CoV-2) Disease has put the world on alert, that is reminiscent of the SARS outbreak seventeen years ago.Objective: We aim to compare the severity and mortality between male and female patients with both COVID-19 and SARS, to explore the most useful prognostic factors for individualized assessment. Design, Setting, and Participants: We extracted the data from a case series of 43 hospitalized patients we treated, a public data set of the first 37 cases died of COVID-19 in Wuhan city and 1019 survived patients from six cities in China. We also analyzed the data of 524 patients with SARS, including 139 deaths, from Beijing city in early 2003. Main Outcomes and Measures: Severity and mortality. Results: Older age and high number of comorbidities were associated with higher severity and mortality in patients with both COVID-19 and SARS. The percentages of older age (≥65 years) were much higher in the deceased group than in the survived group in patients with both COVID-19 (83.8 vs. 13.2, P<0.001) and SARS (37.4 vs.4.9, P<0.001). In the case series, men tend to be more serious than women (P=0.035), although age was comparable between men and women. In the public data set, age was also comparable between men and women in the deceased group or the survived group in patients with COVID-19. Meanwhile, gender distribution was exactly symmetrical in the 1019 survivors of COVID-19. However, the percentage of male were higher in the deceased group than in the survived group (70.3 vs. 50.0, P=0.015).The gender role in mortality was also observed in SARS patients. Survival analysis showed that men (hazard ratio [95% CI] 1.47 [1.05-2.06, P= 0.025) had a . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10. 1101 significantly higher mortality rate than women in patients with SARS. Conclusions and Relevance:Older age and male gender are risk factors for worse outcome in patients with COVID. While men and women have the same susceptibility to both SARS-CoV-2 and SARS-CoV, men may be more prone to have higher severity and mortality independent of age and susceptibility.

Male Gender is A Risk Factor For Sever Form of COVID-19 Illness and Worse Outcome in The Middle East

“…Our results showed higher prevalence of COVID-19 infection in male patients (72%) compared to females (28%). This nding differ from previous reports that showed nearly similar prevalence of the disease among both genders [2,4,8,11]. Interestingly, while our results showed no difference in the age groups between the two genders, male patients were highly vulnerable to the sever-critical form of the COVID-19 disease and to the ICU admission compared to female patients.…”

“…This goes with previous reports that also showed male sex as an independent risk factor for critical and refractory form of the disease compared to women [2,12,13]. Moreover, the fatality rates were found to be also different with male patients have 2-3 times higher mortality rates compared to female patients [6].…”

“…Since the novel coronavirus disease-19 (COVID-19) outbreak in the end of 2019, extra efforts and preparations were made for the identi cation of risk factors that might be responsible for the poor clinical course and outcome of some patients' subpopulations [1]. Better understanding of such risk factors might be essential to improve our response to the disease pandemic through the active use of the available resources including early access to the health system and the intensive care unit (ICU), and the adoption of more precise and targeted therapeutic strategies [2].…”

“…Detailed analysis of the gendered dimensions of the COVID-19 infection and its relationship with the demographic, clinical as well as biochemical and radiological ndings are still scarce [2].…”

Gender Differences in Patients With COVID-19: Focus on Severity and Mortality

“…We thank all patients involved in the study. This manuscript has been released as a pre-print at https://www.medrxiv.org/content/ 10.1101/2020.02.23.20026864v2 (14).…”