Gender Characteristics of the Novel Coronavirus Infection (COVID-19) in Middle-Aged Adults

The aim of the study is to assess the gender-related specifics of the COVID-19 course in patients under 55 years of age.

This pilot single-center continuous retrospective non-randomized study was carried out in the repurposed infectious diseases hospital of the Privolzhsky Research Medical University (Nizhny Novgorod, Russia). The study inclusion criterion was the age of patients (up to 55 years) and confirmed coronavirus infection. In the groups based on gender differences (25 men, average age 44.0±7.8 years and 32 women, average age 41.9±9.1 years), we monitored complications of COVID-19 such as the transfer of patients to the ICU and the volume of lung damage (determined with CT scans).

The course of COVID-19 in male patients younger than 55 was aggravated by concomitant diseases (γ=0.36; p=0.043), among which IHD (γ=1.00; p=0.003) and liver disease (γ=0.58; p=0.007) dominated. Frequency analysis confirmed the high prevalence of coronary artery disease in men (p=0.044). Significant differences between the gender-related groups were noted in the volume of lung lesions: at admission (p=0.050), during hospital treatment (p=0.019), and at discharge (p=0.044). Using the logistic regression method, a relationship was found between the transfer of male patients to ICU and the Krebs index [y= -2.033 + 1.154 male gender + 1.539 Krebs index (χ²=5.68; p=0.059)] and comorbidity [y= -2.836 + 1.081 male gender + 2.052 comorbidity (χ²=7.03; p=0.030)]. The influence of the Krebs index and the male gender on the excess volume of lung lesions was shown [y= -1.962 + 0.575 male gender + 1.915 Krebs index (χ²=7.78; p=0.021)].

In individuals under the age of 55 diagnosed with COVID-19, gender is of significant importance: in men, there is a more pronounced lesion of the lung parenchyma and a more significant change in laboratory parameters. Risk factors for a severe course of COVID-19 in men are coronary artery disease and hepatobiliary disorder. Calculating the Krebs index can be used to assess the risk of disease progression.