Subject: COVID-19
Subject: women
Subject: sex
Subject: mortality
Subject: acute respiratory failure
Subject: acute heart failure
Subject: acute kidney injury
Year: 2023
Type: Article
Title: Sex differences and disparities in cardiovascular outcomes of COVID-19
Author: Bugiardini, Raffaele
Author: Nava, Stefano
Author: Caramori, Gaetano
Author: Yoon, Jinsung
Author: Badimon, Lina
Author: Bergami, Maria
Author: Cenko, Edina
Author: David, Antonio
Author: Demiri, Ilir
Author: Dorobantu, Maria
Author: Fronea, Oana
Author: Jankovic, Radmilo
Author: Kedev Sasko
Author: Ladjevic, Nebojsa
Author: Lasica, Ratko
Author: Loncar, Goran
Author: Mancuso, Giuseppe
Author: Mendieta, Guiomar
Author: Miličić, Davor
Author: Mjehović, Petra
Author: Pašalić, Marijan
Author: Petrović, Milovan
Author: Poposka, Lidija
Author: Scarpone, Marialuisa
Author: Stevanovikj, Milena
Author: van der Schaar, Mihaela
Author: Vasiljevic, Zorana
Author: Vavlukis, Marija
Author: Vega Pittao, Maria Laura
Author: Vukomanovic, Vladan
Author: Zdravkovic, Marija
Author: Manfrini, Olivia
Abstract: Background Previous analyses on sex differences in case fatality rates at population-level data had limited adjustment for key patient clinical characteristics thought to be associated with COVID-19 outcomes. We aimed to estimate the risk of specific organ dysfunctions and mortality in women and men. Methods and Results This retrospective cross-sectional study included 17 hospitals within 5 European countries participating in the International Survey of Acute Coronavirus Syndromes (ISACS) COVID-19(NCT05188612). Participants were individuals hospitalized with positive SARS-CoV-2 from March 2020 to February 2022. Risk-adjusted ratios(RR) of in-hospital mortality, acute respiratory failure(ARF), acute heart failure(AHF), and acute kidney injury(AKI) were calculated for women versus men. Estimates were evaluated by inverse probability of weighting and logistic regression models. The overall care cohort included 4,499 patients with COVID-19 associated hospitalizations. Of these, 1,524(33.9%) were admitted to ICU, and 1,117(24.8%) died during hospitalization. Compared with men, women were less likely to be admitted to ICU (RR:0.80; 95%CI: 0.71–0.91). In general wards (GW) and ICU cohorts, the adjusted women-to-men RRs for in-hospital mortality were of 1.13(95%CI: 0.90–1.42) and 0.86(95%CI: 0.70–1.05; pinteraction=0.04). Development of AHF, AKI and ARF was associated with increased mortality risk (ORs: 2.27; 95%CI; 1.73–2.98,3.85; 95%CI:3.21–4.63 and 3.95; 95%CI:3.04–5.14, respectively). The adjusted RRs for AKI and ARF were comparable among women and men regardless of intensity of care. By contrast, female sex was associated with higher odds for AHF in GW, but not in ICU (RRs:1.25; 95%CI0.94–1.67 versus 0.83; 95%CI:0.59–1.16, pinteraction=0.04). Conclusions Women in GW were at increased risk of AHF and in-hospital mortality for COVID-19 compared with men. For patients receiving ICU care, fatal complications including AHF and mortality appeared to be independent of sex. Equitable access to COVID-19 ICU care is needed to minimize the unfavourable outcome of women presenting with COVID-19 related complications.
Publisher: Oxford University Press (OUP)
Relation: the International Survey of Acute Coronavirus Syndromes (ISACS) COVID-19
Identifier: oai:repository.ukim.mk:20.500.12188/25496
Identifier: Raffaele Bugiardini, Stefano Nava, Gaetano Caramori, Jinsung Yoon, Lina Badimon, Maria Bergami, Edina Cenko, Antonio David, Ilir Demiri, Maria Dorobantu, Oana Fronea, Radmilo Jankovic, Sasko Kedev, Nebojsa Ladjevic, Ratko Lasica, Goran Loncar, Giuseppe Mancuso, Guiomar Mendieta, Davor Miličić, Petra Mjehović, Marijan Pašalić, Milovan Petrović, Lidija Poposka, Marialuisa Scarpone, Milena Stefanovic, Mihaela van der Schaar, Zorana Vasiljevic, Marija Vavlukis, Maria Laura Vega Pittao, Vladan Vukomanovic, Marija Zdravkovic, Olivia Manfrini, Sex differences and disparities in cardiovascular outcomes of COVID-19, Cardiovascular Research, 2023;, cvad011, https://doi.org/10.1093/cvr/cvad011Identifier: http://hdl.handle.net/20.500.12188/25496Identifier: 10.1093/cvr/cvad011
Identifier: https://academic.oup.com/cardiovascres/advance-article-pdf/doi/10.1093/cvr/cvad011/48758016/cvad011.pdfIdentifier: https://academic.oup.com/cardiovascres/advance-article-pdf/doi/10.1093/cvr/cvad011/48758016/cvad011.pdf
