Sex Differences in the Relation between Comorbidities and Prognosis in Hospitalized Patients with COVID-19

There is a lack of information of the difference in sex-aggregated prevalence of comorbid noncommunicable disease (NCD) in patients hospitalized with COVID-19 in Iran. This study aimed to evaluate sex differences in the relation between medical comorbidities and subsequent death in patients hospitalized with COVID-19.

All subsequently hospitalized patients with a diagnosis of moderate to severe COVID-19 since February 19^th to June 14^th, 2020, in Isfahan, Iran, were recruited in the ongoing I-CORE Registry. Real-time reverse-transcription polymerase chain reaction (RT-PCR) testing was done upon admission. Data on preexisting comorbid NCDs including hypertension, coronary heart disease (CHD), diabetes mellitus (DM), cancers, chronic renal disease (CRD), and chronic respiratory disease were collected through self-reported questionnaires.

Overall, 12,620 individuals were enrolled in this registry of which 4,356 were positive for the COVID-19 RT-PCR test. In the whole population, in women, DM, hypertension, and CHD, and in men, DM, CHD, and hypertension were, respectively, the most frequent comorbidities. The frequency of at least one NCD did not differ between men and women, but a greater proportion of women had two or more NCDs. Increasing the number of comorbidities was associated with higher death frequency and mortality risk in the unadjusted model but remained no longer significant after adjustment for age. There was no statistically significant difference in this regard between men and women.

Overall, we found that DM, hypertension, and CHD were the most frequent comorbidities. Although comorbidities were more frequent among women, mortality risk did not significantly differ between men and women.