Background: Although sex differences are described in Coronavirus Disease 2019 (COVID-19) diagnoses and testing, many studies neglect possible gender-related influences. Additionally, research is often performed in clinical populations, while most COVID-19 patients are not hospitalized. Therefore, we investigated associations between sex and gender-related variables, and COVID-19 diagnoses and testing practices in a large general population cohort during the first wave of the pandemic when testing capacity was limited. Methods: We used data from the Lifelines COVID-19 Cohort ( N = 74,722; 60.8% female). We applied bivariate and multiple logistic regression analyses. The outcomes were a COVID-19 diagnosis (confirmed by SARS-CoV-2 PCR testing or physician’s clinical diagnosis) and PCR testing. Independent variables included among others participants’ sex, age, somatic comorbidities, occupation, and smoking status. Sex-by-comorbidity and sex-by-occupation interaction terms were included to investigate sex differences in associations between the presence of comorbidities or an occupation with COVID-19 diagnoses or testing practices. Results: In bivariate analyses female sex was significantly associated with COVID-19 diagnoses and testing, but significance did not persist in multiple logistic regression analyses. However, a gender-related variable, being a health care worker, was significantly associated with COVID-19 diagnoses (OR = 1.68; 95%CI = 1.30–2.17) and testing (OR = 12.5; 95%CI = 8.55–18.3). Female health care workers were less often diagnosed and tested than male health care workers (OR interaction = 0.54; 95%CI = 0.32–0.92, OR interaction = 0.53; 95%CI = 0.29–0.97, respectively). Conclusions: We found no sex differences in COVID-19 diagnoses and testing in the general population. Among health care workers, a male preponderance in COVID-19 diagnoses and testing was observed. This could be explained by more pronounced COVID-19 symptoms in males or by gender inequities.
【저자키워드】 COVID-19, SARS-CoV-2, sex differences, Gender equity, 【초록키워드】 pandemic, Hospitalized, health care workers, Comorbidities, Sex, Gender, outcome, PCR testing, Cohort, Health, male, female, Research, COVID-19 diagnosis, Logistic regression, Health care worker, age, General population, Sex difference, smoking status, Clinical diagnosis, First wave, Care, diagnose, association, Interaction, COVID-19 patient, COVID-19 symptom, SARS-CoV-2 PCR testing, independent variable, participant, interaction term, influences, populations, bivariate analysis, tested, described, performed, significantly, investigated, diagnosed, applied, less, explained, analyses, presence of comorbidity, used data, variables, with COVID-19, 【제목키워드】 Testing, Practice, Wave, difference,