Male predominance in disease severity and mortality in a low Covid-19 epidemic and low case-fatality area - a population-based registry study

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Forsblom , E , Silen , S , Kortela , E , Ahava , M , Kreivi , H-R , Holmberg , V , Järvinen , A , Hästbacka , J , Kivivuori , S-M & Meretoja , A 2021 , ' Male predominance in disease severity and mortality in a low Covid-19 epidemic and low case-fatality area - a population-based registry study ' , Infectious Diseases , vol. 53 , no. 10 , pp. 789-799 . https://doi.org/10.1080/23744235.2021.1936157

Title: Male predominance in disease severity and mortality in a low Covid-19 epidemic and low case-fatality area - a population-based registry study
Author: Forsblom, Erik; Silen, Suvi; Kortela, Elisa; Ahava, Maarit; Kreivi, Hanna-Riikka; Holmberg, Ville; Järvinen, Asko; Hästbacka, Johanna; Kivivuori, Sanna-Maria; Meretoja, Atte
Contributor organization: HUS Inflammation Center
Infektiosairauksien yksikkö
Clinicum
Department of Ophthalmology and Otorhinolaryngology
HUS Head and Neck Center
HUSLAB
HUS Diagnostic Center
University of Helsinki
Helsinki University Hospital Area
HUS Heart and Lung Center
Department of Medicine
Keuhkosairauksien yksikkö
Ville Holmberg's research group / Infections in Migrants
HUS Perioperative, Intensive Care and Pain Medicine
Anestesiologian yksikkö
HUS Children and Adolescents
Date: 2021-10-03
Language: eng
Number of pages: 11
Belongs to series: Infectious Diseases
ISSN: 2374-4235
DOI: https://doi.org/10.1080/23744235.2021.1936157
URI: http://hdl.handle.net/10138/340469
Abstract: Background Men reportedly suffer from a more severe disease and higher mortality during the global SARS-CoV-2 (Covid-19) pandemic. We analysed sex differences in a low epidemic area with low overall mortality in Covid-19 in a population based setting with patients treated in specialized healthcare. Methods We entered all hospitalized laboratory-confirmed Covid-19 cases of all specialized healthcare hospitals of the Capital Province of Finland, into a population-based quality registry and described demographics, severity and case-fatality by sex of the first Covid-19 wave February-June 2020. Results Altogether 5471 patients (49% male) were identified. Patients hospitalized in the specialist healthcare (N = 585, 54% male, OR 1.25; 95% CI 1.05-1.48) were of the same age. Men had less asthma and thyroid insufficiency and more coronary artery disease compared to women. Mean time from symptom onset to diagnosis was at least one day longer for men (p=.005). Men required intensive care unit (ICU) more often (27% vs. 17%) with longer lengths-of-stays at ICU. Male sex associated with significantly higher case-fatality at 90-days (15% vs. 8%) and all excess male deaths occurring after three weeks from onset. Men with fatal outcomes had delays in both Covid-19 testing and hospital admission after a positive test. The delays in patients with the most severe and fatal outcomes differed markedly by sex. In multivariable analysis, male sex associated independently with case-fatality (OR 2.37; 95% CI 1.22-4.59). Conclusions Male sex associated with higher disease severity and case-fatality. Late presentation of male fatal cases could represent different treatment-seeking behaviour or disease progression by sex.
Subject: Covid-19
mortality
male sex
PREVALENCE
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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