Better prognosis in females with severe COVID-19 pneumonia: possible role of inflammation as potential mediator.
COVID-19
COVID-19 pneumonia
Inflammation
Mediation
Prognosis
Sex differences
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
08
08
2020
revised:
07
10
2020
accepted:
08
12
2020
pubmed:
29
12
2020
medline:
17
8
2021
entrez:
28
12
2020
Statut:
ppublish
Résumé
Sex differences in COVID-19 severity and mortality have been described. Key aims of this analysis were to compare the risk of invasive mechanical ventilation (IMV) and mortality by sex and to explore whether variation in specific biomarkers could mediate this difference. This was a retrospective, observational cohort study among patients with severe COVID-19 pneumonia. A survival analysis was conducted to compare time to the composite endpoint of IMV or death according to sex. Interaction was formally tested to compare the risk difference by sex in sub-populations. Mediation analysis with a binary endpoint IMV or death (yes/no) by day 28 of follow-up for a number of inflammation/coagulation biomarkers in the context of counterfactual prediction was also conducted. Among 415 patients, 134 were females (32%) and 281 males (67%), median age 66 years (IQR 54-77). At admission, females showed a significantly less severe clinical and respiratory profiles with a higher PaO Our analysis confirms a difference in the risk of COVID-19 clinical progression by sex and provides a hypothesis for potential mechanisms leading to this. Specifically, CRP showed a predominant role to mediate the difference in risk by sex.
Identifiants
pubmed: 33359539
pii: S1198-743X(20)30765-5
doi: 10.1016/j.cmi.2020.12.010
pmc: PMC7816626
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1137-1144Investigateurs
Erica Bacca
(E)
Andrea Bedini
(A)
Vanni Borghi
(V)
Giulia Burastero
(G)
Federica Carli
(F)
Giacomo Ciusa
(G)
Luca Corradi
(L)
Margherita Di Gaetano
(M)
Matteo Faltoni
(M)
Giacomo Franceschi
(G)
Gabriella Orlando
(G)
Francesco Pellegrino
(F)
Cinzia Puzzolante
(C)
Alessandro Raimondi
(A)
Antonella Santoro
(A)
Marco Tutone
(M)
Dina Yaacoub
(D)
Alberto Andreotti
(A)
Emanuela Biagioni
(E)
Filippo Bondi
(F)
Stefano Busani
(S)
Giovanni Chierego
(G)
Marzia Scotti
(M)
Lucia Serio
(L)
Caterina Bellinazzi
(C)
Rebecca Borella
(R)
Sara De Biasi
(S)
Anna De Gaetano
(A)
Lucia Fidanza
(L)
Lara Gibellini
(L)
Anna Iannone
(A)
Domenico Lo Tartaro
(D)
Marco Mattioli
(M)
Annamaria Paolini
(A)
Rossella Fogliani
(R)
Grazia Righini
(G)
Mario Lugli
(M)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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