Sex Differences in Clinical Characteristics and Outcomes of Patients with SARS-CoV-2-Infection Admitted to Intensive Care Units in Austria

被引:3
|
作者
Kautzky-Willer, Alexandra [1 ,2 ]
Kaleta, Michaela [3 ,4 ]
Lindner, Simon D. [3 ,4 ]
Leutner, Michael [1 ]
Thurner, Stefan [3 ,4 ,5 ]
Klimek, Peter [3 ,4 ]
机构
[1] Med Univ Vienna, Clin Div Endocrinol & Metab, Dept Internal Med 3, Wahringer Gurtel 18-20, A-1090 Vienna, Austria
[2] Gender Inst, A-3571 Gars Am Kamp, Austria
[3] Med Univ Vienna, CeMSIIS, Sect Sci Complex Syst, Spitalgasse 23, A-1090 Vienna, Austria
[4] Complex Sci Hub Vienna, Josefstadter Str 39, A-1080 Vienna, Austria
[5] Santa Fe Inst, 1399 Hyde Pk Rd, Santa Fe, NM 87501 USA
来源
JOURNAL OF PERSONALIZED MEDICINE | 2022年 / 12卷 / 04期
关键词
sex; gender; diabetes; COVID-19; ICU; mortality; GENDER-DIFFERENCES; COVID-19; INPATIENTS; COHORT;
D O I
10.3390/jpm12040517
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Importance: A male predominance is reported in hospitalised patients with COVID-19 alongside a higher mortality rate in men compared to women. Objective: To assess if the reported sex bias in the COVID-19 pandemic is validated by analysis of a subset of patients with severe disease. Design: A nationwide retrospective cohort study was performed using the Austrian National COVID Database. We performed a sex-specific Lasso regression to select the covariates best explaining the outcomes of mechanical ventilation and death using variables known before ICU admission. We use logistic regression to construct a sex-specific "risk score" for the outcomes using these variables. Setting: We studied the characteristics and outcomes of patients admitted to intensive care units (ICUs) in Austria. Participants: 5118 patients admitted to the ICU in Austria with a COVID-19 diagnosis in 03/2020-03/2021. Exposures: Demographic and clinical characteristics, vital signs and laboratory tests, comorbidities, and management of patients admitted to ICUs were analysed for possible sex differences. Main outcomes and measures: The aim was to define risk scores for mechanical ventilation and mortality for each sex to provide better sex-sensitive management and outcomes in the future. Results: We found balanced accuracies between 55% and 65% to predict the outcomes. Regarding outcome death, we found that the risk score for pre-ICU variables increases with age, renal insufficiency (f: OR 1.7(2), m: 1.9(2)) and decreases with observance as admission cause (f: OR 0.33(5), m: 0.36(5)). Additionally, the risk score for females also includes respiratory insufficiency (OR 2.4(4)) while heart failure for males only (OR 1.5(1)). Conclusions and relevance: Better knowledge of how sex influences COVID-19 outcomes at ICUs will have important implications for the ongoing pandemic's clinical care and management strategies. Identifying sex-specific features in individuals with COVID-19 and fatal consequences might inform preventive strategies and public health services.
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页数:11
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