The coronavirus disease 2019 (COVID-19) became a global pandemic. Males, compared to females, seem to be more susceptible to COVID-19, but related evidence is scarce, especially in severe patients. We explored sex differences in clinical characteristics and potential risk factors for mortality in severe COVID-19 patients. In this retrospective cohort study, we included all severe COVID-19 patients admitted to Eastern Renmin Hospital of Wuhan University, Wuhan, China, with a definitive clinical outcome as of Apr 10, 2020. Of the included 651 patients, 332 were male, and 319 were female. Males and females did not differ in age and underlying comorbidities. Males were more likely than females to report fever and develop serious complications, including acute respiratory distress syndrome, secondary infection, acute cardiac injury, coagulopathy, acute kidney injury and arrhythmia. Further, males had much higher mortality relative to females. Multivariable regression showed neutrophilia (odds ratio 6.845, 95% CI 1.227-38.192, p =0.028), thrombocytopenia (19.488, 3.030-25.335, p =0.002), hypersensitive troponin I greater than 0.04 pg/mL (6.058, 1.545-23.755, p =0.010), and procalcitonin greater than 0.1 ng/mL (6.350, 1.396-28.882, p =0.017) on admission were associated with in-hospital death. With either of these risk factors, the cumulative survival rate was relatively lower in males than in females. In conclusion, males are more likely than females to develop serious complications and progress to death. The potential risk factors of neutrophilia, thrombocytopenia, hypersensitive troponin I greater than 0.04 pg/mL and procalcitonin more than 0.1 ng/mL may help clinicians to identify patients with poor outcomes at an early stage, especially in males.
【저자키워드】 COVID-19, Risk factors, Mortality, Sex difference, 【초록키워드】 coronavirus disease, Clinical characteristics, Infection, Comorbidities, procalcitonin, Acute kidney injury, outcome, arrhythmia, Acute cardiac injury, Coagulopathy, Clinical outcome, global pandemic, Fever, Wuhan, male, female, Patient, death, complications, age, survival rate, troponin I, university, Admission, early stage, patients, acute respiratory distress, Evidence, Odds ratio, In-hospital death, retrospective cohort study, Factor, severe patients, 95% CI, clinician, potential risk, Multivariable regression, syndrome, severe COVID-19 patients, help, Renmin Hospital, cumulative, females, susceptible, males, Wuhan, China, serious complication, greater, not differ, identify, develop, much higher, hypersensitive, severe COVID-19 patient, 【제목키워드】 Clinical characteristics, risk factor, Retrospective study, Severe patient,