BACKGROUND: Gender-related factors might affect vulnerability to Covid-19 . The aim of this study was to describe the role of gender on clinical features and 28-day mortality in Covid-19 patients .
METHODS: Observational study of Covid-19 patients hospitalized in Bergamo, Italy, during the first three weeks of the outbreak . Medical records, clinical, radiological and laboratory findings upon admission and treatment have been collected . Primary outcome was 28-day mortality since hospitalization .
RESULTS: 431 consecutive adult patients were admitted . Female patients were 119 (27.6 %) with a mean age of 67.0 ± 14.5 years (vs 67.8 ± 12.5 for males, p = 0.54). Previous history of myocardial infarction, vasculopathy and former smoking habits were more common for males . At the time of admission PaO 2 /FiO 2 was similar between men and women (228 [IQR , 134-273] vs 238 mmHg [150-281], p = 0.28). Continuous Positive Airway Pressure (CPAP) assistance was needed in the first 24 h more frequently in male patients (25.7% vs 13.0% ; p = 0.006). Overall 28-day mortality was 26.1% in women and 38.1% in men (p = 0.018). Gender did not result an independent predictor of death once the parameters related to disease severity at presentation were included in the multivariable analysis (p = 0.898). Accordingly, the Kaplan-Meier survival analysis in female and male patients requiring CPAP or non-invasive ventilation in the first 24 h did not find a significant difference (p = 0.687).
CONCLUSION: Hospitalized women are less likely to die from Covid-19; however, once severe disease occurs, the risk of dying is similar to men . Further studies are needed to better investigate the role of gender in clinical course and outcome of Covid-19.
MeSH: Aged, Aged, 80 and over, COVID-19, epidemiology, mortality, physiopathology, therapy, Comorbidity, Continuous Positive Airway Pressure, statistics & numerical data, Diabetes Mellitus, epidemiology, Female, Humans, Hypertension, epidemiology, Hypoxia, epidemiology, physiopathology, therapy, Italy, epidemiology, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction, epidemiology, Noninvasive Ventilation, statistics & numerical data, SARS-CoV-2, Severity of Illness Index, Sex Factors, Smoking, epidemiology
Index: Covid-19, Disease severity, Gender