Abstract
BackgroundAdvancing age and male sex have been identified as risk factors for poor outcomes in coronavirus disease 2019 (COVID-19). However, there is a dearth of data investigating the impact of age on the risk reported with male sex. We aimed to determine the risk associated with male sex in people of different age groups, that is, in people younger or older than 65 years of age.MethodsThis is a retrospective cohort study that included 370 adult patients hospitalized with COVID-19 between March 12, 2020, and May 13, 2020, at a 242-bed teaching community hospital in the New York City metropolitan region. Patients were classified into younger (age<65 years, n=132) and older individuals (age>=65, n=238). We calculated odds ratios for poor outcomes in men compared to women separately in these two groups.ResultsAmong older individuals, there was no difference in the odds of poor outcomes between men and women. In contrast, among younger people, men had higher odds of severe pneumonia, need for high oxygen support, acute kidney injury and acute liver injury when compared to women.ConclusionsAmong people older than 65 years, sex did not impact disease severity and outcomes in COVID-19. Thus, older women were equally likely to have severe COVID-19 when compared to age-matched men. In contrast, among younger middle-aged adults (29-64 years), men had higher odds of end-organ damage from COVID-19 compared to women. Based on these observations, age is a more important driver of poor outcomes in COVID-19 than sex. Public health policies need to create awareness for the increased risk of older individuals to COVID-19, regardless of sex.
Highlights
At the time of writing, 13 million cases of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been described worldwide, resulting in 571,000 deaths [1]
Among younger people, men had higher odds of severe pneumonia, need for high oxygen support, acute kidney injury and acute liver injury when compared to women
Older women were likely to have severe COVID-19 when compared to age-matched men
Summary
At the time of writing, 13 million cases of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been described worldwide, resulting in 571,000 deaths [1]. Advancing age and male sex have been independently identified as risk factors for poor outcomes in COVID19 illness [3,4,5,6]. There is a dearth of data describing the impact of sex on outcomes in older individuals (age>=65 years). We investigated the risk associated with male sex in people of different age-groups, that is, in people younger or older than 65 years of age. Advancing age and male sex have been identified as risk factors for poor outcomes in coronavirus disease 2019 (COVID-19). There is a dearth of data investigating the impact of age on the risk reported with male sex. We aimed to determine the risk associated with male sex in people of different age groups, that is, in people younger or older than 65 years of age
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