Longer Hospital Stays, Greater Risk of COVID-19 Death in Men

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New research presented at the 2020 ESCMID Conference on Coronavirus Disease (ECCVID) show that men with COVID-19 have worse outcomes than women, possibly related to them experiencing higher levels of inflammation.

The study by Frank Hanses, MD, University Hospital Regensburg, Germany, and colleagues, shows that men have a 62% increased risk of COVID-19-associated death compared with women, after adjustment for various factors.

Increasing evidence suggests a sex difference in SARS-CoV-2 infections. In this study, the authors present a first analysis of the international multicenter Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) dataset on the impact of sex in COVID-19. They retrospectively assessed 3,129 adult patients with COVID-19, enrolled between March and July 2020.

The male:female ratio in this mostly hospital-based cohort was 1.48 with a male predominance in all age groups. Male predominance was even more pronounced in the age groups >65 years and >75 years.

Most comorbidities did not differ significantly between men and women, while coronary artery disease (18% vs 10%) and smoking rates (14.5 vs 10.5%) were higher in male patients than female patients.

Progression to a critical phase (generally reflecting ICU admission) was seen more often in men than in women (30.6% vs 17.2%). Mean hospital length of stay was longer in male patients (15.4 vs 13.3 days).

Both crude mortality (19.2% vs 12.9%) and COVID-19 attributable mortality (17.1% vs 10.3%) were significantly higher in men.

While most laboratory parameters were comparable between male and female patients with COVID-19, men had significantly higher inflammatory markers (IL-6, CRP, PCT, ferritin) across all phases of disease.

Expert commentary:

Question: What are the clinical implications of your research for men?

Hanses: "Both men (and their treating physicians) should be aware of the fact that men have a worse outcome/higher risk (the main drawback being that we cannot provide a good explanation or different treatment suggestion yet)."

References: Hanses F, et al. Abstract 00363. Men are disproportionally affected by COVID 19: Outcome and degree of inflammation in a large international cohort. ECCVID 2020. 23-25 September 2020.

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This article originally appeared on Univadis, part of the Medscape Professional Network.

Medscape Medical News © 2020 

Cite this: Longer Hospital Stays, Greater Risk of COVID-19 Death in Men - Medscape - Oct 08, 2020.