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Gender-based disparities in COVID-19 patient outcomes
Paul Ellis Marik1, Sarah E DePerrior2, Qamar Ahmad3
1Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA marikpe@evms.edu.
Summary
Men with COVID-19 experienced more severe disease and worse outcomes than women. This heightened inflammatory response in men, indicated by higher C-reactive protein (CRP) and ferritin levels, likely contributes to disease severity.
Area of Science:
- Infectious Diseases
- Immunology
- Medical Research
Background:
- Emerging evidence suggests COVID-19 severity differs between sexes.
- The underlying biological mechanisms for sex-based differences in COVID-19 outcomes remain unclear.
Purpose of the Study:
- To compare clinical characteristics, inflammatory biomarkers, and outcomes between male and female COVID-19 patients.
- To investigate potential sex-based differences in the inflammatory response to SARS-CoV-2 infection.
Main Methods:
- Retrospective analysis of 701 COVID-19 patients admitted to 10 Virginia hospitals (January-June 2020).
- Comparison of demographic data, comorbidities, inflammatory markers (CRP, D-dimer, ferritin, neutrophil:lymphocyte ratio), and clinical outcomes between men and women.
- Statistical analysis to determine significant differences between sexes.
Main Results:
- No significant differences in age, race, or comorbidities between men and women.
- Men exhibited significantly higher baseline and peak levels of C-reactive protein (CRP) and ferritin.
- Men showed significantly higher maximal D-dimer levels and increased intensive care unit (ICU) admission rates, with borderline higher mortality.
Conclusions:
- COVID-19 disease severity is greater in men compared to women.
- The heightened inflammatory response in men, evidenced by elevated inflammatory markers, likely contributes to increased disease severity.
- Sex-based differences in inflammatory response, not age or comorbidities, may explain the observed disparities in COVID-19 outcomes.
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