Gender Differences in the Presentation and Outcomes of Hospitalized Patients With COVID‐19
Carloalberto Biolè, Matteo Bianco, Iván J. Núñez‐Gil, Enrico Cerrato, A. Spirito, Sergio Raposeiras‐Roubín, María C. Viana‐Llamas, Adelina González, Alex F. Castro‐Mejía, Charbel Maroun‐Eid, Cristina Fernández, Aitor Uribarri, Emilio Alfonso‐Rodríguez, Fabrizio Ugo, Federico Guerra, Gisela Feltes, İbrahim Akın, Inmaculada Fernández‐Rozas, Natividad Blasco‐Angulo, Jia Huang, Marcos Garcı́a Aguado, Martino Pepe, Rodolfo Romero, Víctor Manuel Becerra‐Muñoz, Vicente Estrada, Carlos Macaya
Abstract
Gender-related differences in COVID-19 clinical presentation, disease progression, and mortality have not been adequately explored. We analyzed the clinical profile, presentation, treatments, and outcomes of patients according to gender in the HOPE-COVID-19 International Registry. Among 2,798 enrolled patients, 1,111 were women (39.7%). Male patients had a higher prevalence of cardiovascular risk factors and more comorbidities at baseline. After propensity score matching, 876 men and 876 women were selected. Male patients more often reported fever, whereas female patients more often reported vomiting, diarrhea, and hyposmia/anosmia. Laboratory tests in men presented alterations consistent with a more severe COVID-19 infection (eg, significantly higher C-reactive protein, troponin, transaminases, lymphocytopenia, thrombocytopenia, and ferritin). Systemic inflammatory response syndrome, bilateral pneumonia, respiratory insufficiency, and renal failure were significantly more frequent in men. Men more often required pronation, corticosteroids, and tocilizumab administration. A significantly higher 30-day mortality was observed in men vs women (23.4% vs 19.2%; P = .039). Trial Numbers: NCT04334291/EUPAS34399.