Determine if sex differences exist in clinical characteristics and outcomes of adults hospitalized for coronavirus disease 2019 (COVID-19) in a US healthcare system. Case series study. Sequentially hospitalized adults admitted for COVID-19 at two tertiary care academic hospitals in New Orleans, LA, between 27 February and 15 July 2020. Measures included demographics, comorbidities, presenting symptoms, and laboratory results. Outcomes included intensive care unit admission (ICU), invasive mechanical ventilation (IMV), and in-hospital death. We included 776 patients (median age 60.5 years; 61.4% women, 75% non-Hispanic Black). Rates of ICU, IMV, and death were similar in both sexes. In women versus men, obesity (63.8 vs 41.6%, P < 0.0001), hypertension (77.6 vs 70.1%, P = 0.02), diabetes (38.2 vs 31.8%, P = 0.06), chronic obstructive pulmonary disease (COPD, 22.1 vs 15.1%, P = 0.015), and asthma (14.3 vs 6.9%, P = 0.001) were more prevalent. More women exhibited dyspnea (61.2 vs 53.7%, P = 0.04), fatigue (35.7 vs 28.5%, P = 0.03), and digestive symptoms (39.3 vs 32.8%, P = 0.06) than men. Obesity was associated with IMV at a lower BMI (> 35) in women, but the magnitude of the effect of morbid obesity (BMI ≥ 40) was similar in both sexes. COPD was associated with ICU (adjusted OR (aOR), 2.6; 95%CI, 1.5–4.3) and IMV (aOR, 1.8; 95%CI, 1.2–3.1) in women only. Diabetes (aOR, 2.6; 95%CI, 1.2–2.9), chronic kidney disease (aOR, 2.2; 95%CI, 1.3–5.2), elevated neutrophil-to-lymphocyte ratio (aOR, 2.5; 95%CI, 1.4–4.3), and elevated ferritin (aOR, 3.6; 95%CI, 1.7–7.3) were independent predictors of death in women only. In contrast, elevated D-dimer was an independent predictor of ICU (aOR, 7.3; 95%CI, 2.7–19.5), IMV (aOR, 6.5; 95%CI, 2.1–20.4), and death (aOR, 4.5; 95%CI, 1.2–16.4) in men only. This study highlights sex disparities in clinical determinants of severe outcomes in COVID-19 patients that may inform management and prevention strategies to ensure gender equity.

中文翻译：

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新奥尔良 2019 年因冠状病毒病住院的女性和男性的临床特征和结果


确定在美国医疗保健系统中因 2019 年冠状病毒病 (COVID-19) 住院的成年人的临床特征和结果是否存在性别差异。案例系列研究。 2020 年 2 月 27 日至 7 月 15 日期间，路易斯安那州新奥尔良两家三级护理学术医院因 COVID-19 入院的成年人。测量指标包括人口统计数据、合并症、出现的症状和实验室结果。结果包括重症监护病房 (ICU) 入院、有创机械通气 (IMV) 和院内死亡。我们纳入了 776 名患者（中位年龄 60.5 岁；61.4% 为女性，75% 为非西班牙裔黑人）。两性的 ICU、IMV 和死亡率相似。在女性与男性中，肥胖（63.8 vs 41.6%，P < 0.0001）、高血压（77.6 vs 70.1%，P = 0.02）、糖尿病（38.2 vs 31.8%，P = 0.06）、慢性阻塞性肺疾病（COPD，22.1）与 15.1%，P = 0.015）和哮喘（14.3% 对 6.9%，P = 0.001）更为普遍。与男性相比，更多女性出现呼吸困难（61.2% vs 53.7%，P = 0.04）、疲劳（35.7% vs 28.5%，P = 0.03）和消化系统症状（39.3 vs 32.8%，P = 0.06）。女性体重指数较低 (> 35) 时，肥胖与 IMV 相关，但病态肥胖 (BMI ≥ 40) 的影响程度在两性中相似。仅在女性中，COPD 与 ICU（调整后 OR (aOR)，2.6；95%CI，1.5-4.3）和 IMV（aOR，1.8；95%CI，1.2-3.1）相关。糖尿病（aOR，2.6；95%CI，1.2–2.9）、慢性肾病（aOR，2.2；95%CI，1.3–5.2）、中性粒细胞与淋巴细胞比率升高（aOR，2.5；95%CI，1.4– 4.3）和铁蛋白升高（aOR，3.6；95%CI，1.7-7.3）仅是女性死亡的独立预测因素。相反，D-二聚体升高是 ICU（aOR，7.3；95%CI，2.7-19.5）、IMV（aOR，6.5；95%CI，2.1-20.4）和死亡（aOR，4.5；95）的独立预测因子。 %CI，1.2–16。4) 仅适用于男性。这项研究强调了 COVID-19 患者严重后果的临床决定因素中的性别差异，这可能为确保性别平等的管理和预防策略提供信息。