Sex disparities in COVID-19 outcomes of inpatients with diabetes: insights from the CORONADO study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tramunt Blandine, Smati Sarra, Coudol Sandrine, Wargny Matthieu, Pichelin Matthieu, Guyomarch Béatrice, Al-Salameh Abdallah, Amadou Coralie, Barraud Sara, Bigot Edith, Bordier Lyse, Borot Sophie, Bourgeon Muriel, Bourron Olivier, Charrière Sybil, Chevalier Nicolas, Cosson Emmanuel, Fève Bruno, Flaus-Furmaniuk Anna, Fontaine Pierre, Galioot Amandine, Gonfroy-Leymarie Céline, Guerci Bruno, Lablanche Sandrine, Lalau Jean-Daniel, Larger Etienne, Lasbleiz Adèle, Laviolle Bruno, Marre Michel, Munch Marion, Potier Louis, Prevost Gaëtan, Renard Eric, Reznik Yves, Seret-Bégué Dominique, Sibilia Paul, Thuillier Philippe, Vergès Bruno, Gautier Jean-François, Hadjadj Samy, Cariou Bertrand, Mauvais-Jarvis Franck, Gourdy Pierre
Аннотация
METHODS: We performed a sex-stratified analysis of clinical and biological features and outcomes (i.e. invasive mechanical ventilation (IMV), death, intensive care unit (ICU) admission and home discharge at day 7 (D7) or day 28 (D28)) in 2380 patients with diabetes hospitalized for COVID-19 and included in the nationwide CORONADO observational study (NCT04324736).
RESULTS: The study population was predominantly male (63.5%). After multiple adjustments, female sex was negatively associated with the primary outcome (IMV and/or death, OR: 0.66 (0.49-0.88)), death (OR: 0.49 (0.30-0.79)) and ICU admission (OR: 0.57 (0.43-0.77)) at D7 but only with ICU admission (OR: 0.58 (0.43-0.77)) at D28. Older age and a history of microvascular complications were predictors of death at D28 in both sexes, while chronic obstructive pulmonary disease (COPD) was predictive of death in women only. At admission, C-reactive protein (CRP), aspartate amino transferase (AST) and estimated glomerular filtration rate (eGFR), according to the CKD-EPI formula predicted death in both sexes. Lymphocytopenia was an independent predictor of death in women only, while thrombocytopenia and elevated plasma glucose concentration were predictors of death in men only.
CONCLUSIONS: In patients with diabetes admitted for COVID-19, female sex was associated with lower incidence of early severe outcomes, but did not influence the overall in-hospital mortality, suggesting that diabetes mitigates the female protection from COVID-19 severity. Sex-associated biological determinants may be useful to optimize COVID-19 prevention and management in women and men.