Erik Forsblom1, Suvi Silén2, Elisa Kortela1, Maarit Ahava3, Hanna-Riikka Kreivi4, Ville Holmberg1,5, Asko Järvinen1, Johanna Hästbacka6, Sanna-Maria Kivivuori7, Atte Meretoja8. 1. Division of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland. 2. Department of Otorhinolaryngology-Head and Neck Center, Helsinki University Hospital, Helsinki, Finland. 3. Diagnostic Center, Clinical Microbiology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 4. Division of Respiratory Diseases, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland. 5. Department of Medicine, Clinicum, University of Helsinki, Helsinki, Finland. 6. Department of Anesthesiology, Intensive Care and Pain Medicine, Division of Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. 7. Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 8. General Administration, Helsinki University Hospital, Helsinki, Finland.
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.
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.
Authors: Xiao-Huan Ma; Meng-Meng An; Fang Yin; Jie Zhang; Meng-Yun Peng; Hong Guan; Ping Gong Journal: J Int Med Res Date: 2022-05 Impact factor: 1.573
Authors: Ville Holmberg; Heli Salmi; Salla Kattainen; Jukka Ollgren; Anu Kantele; Juulia Pynnönen; Asko Järvinen; Erik Forsblom; Suvi Silén; Sanna-Maria Kivivuori; Atte Meretoja; Johanna Hästbacka Journal: Clin Microbiol Infect Date: 2021-09-30 Impact factor: 8.067