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The hidden interplay between sex and COVID-19 mortality: the role of cardiovascular calcification
GeroScience ( IF 5.6 ) Pub Date : 2021-07-14 , DOI: 10.1007/s11357-021-00409-y
Alberto Cereda 1, 2 , Marco Toselli 1 , Anna Palmisano 3, 4 , Davide Vignale 3, 4 , Riccardo Leone 3, 4 , Valeria Nicoletti 3, 4 , Chiara Gnasso 3, 4 , Antonio Mangieri 1 , Arif Khokhar 1 , Gianluca Campo 5 , Alessandra Scoccia 5 , Matteo Bertini 5 , Marco Loffi 6 , Pietro Sergio 6 , Daniele Andreini 7 , Gianluca Pontone 7 , Gianmarco Iannopollo 8 , Tommaso Nannini 8 , Davide Ippolito 9 , Giacomo Bellani 9 , Gianluigi Patelli 10 , Francesca Besana 10 , Luigi Vignali 11 , Nicola Sverzellati 11 , Mario Iannaccone 12 , Paolo Giacomo Vaudano 12 , Giuseppe Massimo Sangiorgi 13 , Piergiorgio Turchio 14 , Alberto Monello 14 , Gabriele Tumminello 4 , Aldo Pietro Maggioni 1 , Claudio Rapezzi 1, 5 , Antonio Colombo 1 , Francesco Giannini 1 , Antonio Esposito 3, 4
Affiliation  

Recent clinical and demographical studies on COVID-19 patients have demonstrated that men experience worse outcomes than women. However, in most cases, the data were not stratified according to gender, limiting the understanding of the real impact of gender on outcomes. This study aimed to evaluate the disaggregated in-hospital outcomes and explore the possible interactions between gender and cardiovascular calcifications. Data was derived from the sCORE-COVID-19 registry, an Italian multicentre registry that enrolled COVID-19 patients who had undergone a chest computer tomography scan on admission. A total of 1683 hospitalized patients (mean age 67±14 years) were included. Men had a higher prevalence of cardiovascular comorbidities, a higher pneumonia extension, more coronary calcifications (63% vs.50.9%, p<0.001), and a higher coronary calcium score (391±847 vs. 171±479 mm3, p<0.001). Men experienced a significantly higher mortality rate (24.4% vs. 17%, p=0.001), but the death event tended to occur earlier in women (15±7 vs. 8±7 days, p= 0.07). Non-survivors had a higher coronary, thoracic aorta, and aortic valve calcium score. Female sex, a known independent predictor of a favorable outcome in SARS-CoV2 infection, was not protective in women with a coronary calcification volume greater than 100 mm3. There were significant differences in cardiovascular comorbidities and vascular calcifications between men and women with SARS-CoV2 pneumonia. The differences in outcomes can be at least partially explained by the different cardiovascular profiles. However, women with poor outcomes had the same coronary calcific burden as men. The presumed favorable female sex bias in COVID-19 must therefore be reviewed in the context of comorbidities, especially cardiovascular ones.



中文翻译:

性别与 COVID-19 死亡率之间隐藏的相互作用:心血管钙化的作用

最近对 COVID-19 患者的临床和人口统计学研究表明,男性的预后比女性差。然而,在大多数情况下,数据没有根据性别分层,限制了对性别对结果的真正影响的理解。本研究旨在评估分解的住院结果,并探讨性别与心血管钙化之间可能的相互作用。数据来自 sCORE-COVID-19 登记处,这是一个意大利多中心登记处,招募了入院时接受胸部计算机断层扫描的 COVID-19 患者。共纳入 1683 名住院患者(平均年龄 67±14 岁)。男性心血管合并症的患病率更高,肺炎扩散程度更高,冠状动脉钙化程度更高(63% 对 50.9%,p<0.001),3 , p < 0.001)。男性的死亡率明显更高(24.4% 对 17%,p = 0.001),但女性的死亡事件往往发生得更早(15±7 天对 8±7 天,p = 0.07)。非幸存者的冠状动脉、胸主动脉和主动脉瓣钙化评分较高。女性是 SARS-CoV2 感染良好结果的已知独立预测因子,但对冠状动脉钙化体积大于 100 mm 3 的女性没有保护作用. 患有 SARS-CoV2 肺炎的男性和女性在心血管合并症和血管钙化方面存在显着差异。结果的差异至少可以部分由不同的心血管特征来解释。然而,结果不佳的女性与男性具有相同的冠状动脉钙化负担。因此,必须在合并症,尤其是心血管疾病的背景下审查 COVID-19 中假定的有利女性性别偏见。

更新日期:2021-07-14
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