Coronavirus disease 2019 (COVID-19) severity seems to be influenced by genetic background, sex, age, and presence of specific comorbidities. So far, little attention has been paid to sex-specific variations of demographic, clinical, and laboratory features of COVID-19 patients referred to the same hospital in the two consecutive pandemic waves. Demographic, clinical, and laboratory data were collected in 1000 COVID-19 patients (367 females and 633 males), 500 hospitalized in the first wave and 500 in the second one, at the ASST Spedali Civili of Brescia from March to December 2020. Statistical analyses have been employed to compare data obtained in females and males, taking into account their age, and during the first and second COVID-19 waves. The mean age at the time of hospitalization was similar in females and males but was significantly higher for both in the second wave; the time elapsed from symptom onset to hospital admission did not differ between sexes in the two waves, and no correlation was observed between delayed hospital admission and length of hospitalization. The number of multi-symptomatic males was higher than that of females, and patients with a higher number of comorbidities were more frequently admitted to intensive care unit (ICU) and more frequently died. Older males remained in the ICU longer than females and showed a longer disease duration, mainly the first wave. The highest levels of white blood cells, neutrophils, C-reactive protein, and fibrinogen were significantly higher in males and in the first, and along with higher levels of D-dimer, ferritin, lactate dehydrogenase, and procalcitonin which were preferentially documented in patients requiring ICU or died. While the rate of death in ICU was higher in males, the overall death rate did not differ between the sexes; however, the deceased women were older. These data indicate that once patients were hospitalized, the risk of dying was similar between females and males. Therefore, future studies should aim at understanding the reasons why, for a given number of SARS-CoV-2 infections, fewer females develop the disease requiring hospitalization.

中文翻译：

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第一波和第二波大流行期间住院的意大利 COVID-19 患者队列中的性别差异

2019 年冠状病毒病 (COVID-19) 的严重程度似乎受到遗传背景、性别、年龄和特定合并症的影响。到目前为止，很少有人关注连续两波大流行浪潮中转诊至同一家医院的 COVID-19 患者的人口统计学、临床和实验室特征的性别特异性差异。2020 年 3 月至 12 月期间，布雷西亚 ASST Spedali Civili 收集了 1000 名 COVID-19 患者（367 名女性和 633 名男性）的人口统计、临床和实验室数据，其中第一波住院人数为 500 人，第二波住院人数为 500 人。已采用分析来比较在女性和男性中获得的数据，考虑到他们的年龄以及第一波和第二波 COVID-19 期间的数据。女性和男性住院时的平均年龄相似，但在第二波中，女性和男性的平均年龄均显着较高；在两波中，从症状出现到入院的时间在性别之间没有差异，并且延迟入院与住院时间之间没有观察到相关性。患有多种症状的男性人数高于女性，合并症数量较多的患者入住重症监护病房（ICU）的频率更高，死亡的频率也更高。老年男性比女性在 ICU 停留的时间更长，并且病程更长，主要是第一波。白细胞、中性粒细胞、C 反应蛋白和纤维蛋白原的最高水平在男性和第一组中显着较高，并且 D-二聚体、铁蛋白、乳酸脱氢酶和降钙素原的水平也较高，这些在患者中优先记录需要重症监护室或死亡。虽然 ICU 中男性的死亡率较高，但总体死亡率在性别之间没有差异；然而，死去的妇女年龄较大。这些数据表明，一旦患者住院，女性和男性的死亡风险相似。因此，未来的研究应旨在了解为什么在一定数量的 SARS-CoV-2 感染中，女性患上需要住院治疗的疾病的人数较少。