Sex differences among inpatients with AECOPD in a tertiary hospital during the COVID-19 pandemic.

BACKGROUND: Although sex differences in the characteristics and prognosis of chronic obstructive pulmonary disease (COPD) are well-documented, it is overlooked in the acute exacerbation of COPD (AECOPD). We aimed to examine sex differences among patients with AECOPD who were hospitalized in a tertiary hospital during the pandemic. METHODS: This retrospective study included 199 females and 199 males among 2426 AECOPD patients who were hospitalized between March 2020 and 2022. Characteristics, modified Charlson Comorbidity Index (mCCI) scores, and long-term survival rate were compared based on sex. Associations between sex and variables were analyzed using the Chi-Square test. RESULTS: Females were older than males (P = 0.02). Females had higher body mass index and pulmonary function test values than males (P = 0.00 for both). GOLD 3, comorbidities, radiological findings, respiratory failure, and biomass exposure were more frequent in females, whereas smoking was more frequent in males (P = 0.00 for all). Among the causes of exacerbations, cardiac events and pneumonia were more frequent in females (P = 0.00 and P = 0.01, respectively), whereas tracheobronchial infections were more frequent in males (P = 0.02). Exacerbations and hospitalizations in the previous year were more prevalent in females than in males (P = 0.00); however, exacerbations during the pandemic were less prevalent (P = 0.00). Hemoglobin, hematocrit, and platelet/lymphocyte levels were higher in males than in females (P = 0.00, P = 0.00, and P = 0.04). Males were more likely than females to have received the BioNTech vaccine (P = 0.02). Compared with males, females had higher mCCI scores and lower 10-year life expectancies (P = 0.00 for both). Females with a COVID-19 history had higher mCCI scores and lower 10-year life expectancies than males with a COVID-19 history (P = 0.00 for both). The long-term survival rate was higher in females than in males (P = 0.04). CONCLUSIONS: The sex-specific characteristics identified in this study may help guide the management of AECOPD in future pandemics.