Abstract
Spain is one of the countries most affected by the COVID-19 pandemic. Although risk factors for severe disease are published, sex differences have been widely neglected. In this multicentre study, we aimed to identify predictors of in-hospital mortality in men and women hospitalised with COVID-19. An observational longitudinal study was conducted in the cohort of patients admitted to four hospitals in Andalusia, Spain, from 1 March 2020 to 15 April 2020. Sociodemographic and clinical data were collected from hospital records. The Kaplan–Meier method was used to estimate 30-day survival and multiple Cox regression models were applied. All analyses were stratified by sex. A total of 968 patients were included (54.8% men, median age 67.0 years). In-hospital mortality reached 19.1% in men and 16.0% in women. Factors independently associated with an increased hazard of death were advanced age, higher CURB-65 score and not receiving azithromycin treatment, in both sexes; active cancer and autoimmune disease, in men; cardiovascular disease and chronic lung disease, in women. Disease outcomes and predictors of death differed between sexes. In-hospital mortality was higher in men, but the long-term effects of COVID-19 merit further research. The sex-differential impact of the pandemic should be addressed in public health policies.
Highlights
We considered the main outcome for patients who died during the first admission and for those readmitted due to COVID-19 who died during readmission
We utilized an anonymized database that was designed for this study and identifying variables were removed for analysis
After excluding one patient aged < 18 years, there were 530 men (55%) and 438 women (45%) diagnosed with COVID-19 admitted to the participating hospitals
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Has quickly spread across the globe causing devastating effects. With more than 3.8 million confirmed cases and 80,000 reported deaths as of 30 June 2021 [1], the burden of disease attributable to COVID-19 in Spain is among the highest in the world, not to mention the indirect effects on other diseases. Coronavirus hit hardest in the first wave of the pandemic, characterised by the lack of preparedness from a public health standpoint, the use of drugs with insufficient evidence and, above all, an unprecedented health care collapse.
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