Sandeep Appunni, Muni Rubens, Venkataraghavan Ramamoorthy, Anshul Saxena, Mayur Doke, Mukesh Roy, Juan Gabriel Ruiz-Pelaez, Yanjia Zhang, Md Ashfaq Ahmed, Zhenwei Zhang, Peter McGranaghan, Sandra Chaparro, Javier Jimenez
{"title":"COVID-19 住院病例中住院结果的性别差异。","authors":"Sandeep Appunni, Muni Rubens, Venkataraghavan Ramamoorthy, Anshul Saxena, Mayur Doke, Mukesh Roy, Juan Gabriel Ruiz-Pelaez, Yanjia Zhang, Md Ashfaq Ahmed, Zhenwei Zhang, Peter McGranaghan, Sandra Chaparro, Javier Jimenez","doi":"10.14423/SMJ.0000000000001654","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Many epidemiological studies have shown that coronavirus disease 2019 (COVID-19) disproportionately affects males, compared with females, although other studies show that there were no such differences. The aim of the present study was to assess differences in the prevalence of hospitalizations and in-hospital outcomes between the sexes, using a larger administrative database.</p><p><strong>Methods: </strong>We used the 2020 California State Inpatient Database for this retrospective analysis. <i>International Classification of Diseases, Tenth Revision, Clinical Modification</i> diagnosis code U07.1 was used to identify COVID-19 hospitalizations. These hospitalizations were subsequently stratified by male and female sex. Diagnosis and procedures were identified using the <i>International Classification of Diseases, Tenth Revision, Clinical Modification</i> codes. The primary outcome of the study was hospitalization rate, and secondary outcomes were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and intensive care unit (ICU) admission.</p><p><strong>Results: </strong>There were 95,180 COVID-19 hospitalizations among patients 18 years and older, 52,465 (55.1%) of which were among men and 42,715 (44.9%) were among women. In-hospital mortality (12.4% vs 10.1%), prolonged length of hospital stays (30.6% vs 25.8%), vasopressor use (2.6% vs 1.6%), mechanical ventilation (11.8% vs 8.0%), and ICU admission rates (11.4% versus 7.8%) were significantly higher among male compared with female hospitalizations. Conditional logistic regression analysis showed that the odds of mortality (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.38-1.44), hospital lengths of stay (OR 1.35, 95% CI 1.31-1.39), vasopressor use (OR 1.59, 95% CI 1.51-1.66), mechanical ventilation (OR 1.62, 95% CI 1.47-1.78), and ICU admission rates (OR 1.58, 95% CI 1.51-1.66) were significantly higher among male hospitalizations.</p><p><strong>Conclusion: </strong>Our findings show that male sex is an independent and strong risk factor associated with COVID-19 severity.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gender Differences in Hospital Outcomes among COVID-19 Hospitalizations.\",\"authors\":\"Sandeep Appunni, Muni Rubens, Venkataraghavan Ramamoorthy, Anshul Saxena, Mayur Doke, Mukesh Roy, Juan Gabriel Ruiz-Pelaez, Yanjia Zhang, Md Ashfaq Ahmed, Zhenwei Zhang, Peter McGranaghan, Sandra Chaparro, Javier Jimenez\",\"doi\":\"10.14423/SMJ.0000000000001654\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Many epidemiological studies have shown that coronavirus disease 2019 (COVID-19) disproportionately affects males, compared with females, although other studies show that there were no such differences. The aim of the present study was to assess differences in the prevalence of hospitalizations and in-hospital outcomes between the sexes, using a larger administrative database.</p><p><strong>Methods: </strong>We used the 2020 California State Inpatient Database for this retrospective analysis. <i>International Classification of Diseases, Tenth Revision, Clinical Modification</i> diagnosis code U07.1 was used to identify COVID-19 hospitalizations. These hospitalizations were subsequently stratified by male and female sex. Diagnosis and procedures were identified using the <i>International Classification of Diseases, Tenth Revision, Clinical Modification</i> codes. The primary outcome of the study was hospitalization rate, and secondary outcomes were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and intensive care unit (ICU) admission.</p><p><strong>Results: </strong>There were 95,180 COVID-19 hospitalizations among patients 18 years and older, 52,465 (55.1%) of which were among men and 42,715 (44.9%) were among women. In-hospital mortality (12.4% vs 10.1%), prolonged length of hospital stays (30.6% vs 25.8%), vasopressor use (2.6% vs 1.6%), mechanical ventilation (11.8% vs 8.0%), and ICU admission rates (11.4% versus 7.8%) were significantly higher among male compared with female hospitalizations. Conditional logistic regression analysis showed that the odds of mortality (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.38-1.44), hospital lengths of stay (OR 1.35, 95% CI 1.31-1.39), vasopressor use (OR 1.59, 95% CI 1.51-1.66), mechanical ventilation (OR 1.62, 95% CI 1.47-1.78), and ICU admission rates (OR 1.58, 95% CI 1.51-1.66) were significantly higher among male hospitalizations.</p><p><strong>Conclusion: </strong>Our findings show that male sex is an independent and strong risk factor associated with COVID-19 severity.</p>\",\"PeriodicalId\":22043,\"journal\":{\"name\":\"Southern Medical Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Southern Medical Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.14423/SMJ.0000000000001654\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Southern Medical Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.14423/SMJ.0000000000001654","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Gender Differences in Hospital Outcomes among COVID-19 Hospitalizations.
Objectives: Many epidemiological studies have shown that coronavirus disease 2019 (COVID-19) disproportionately affects males, compared with females, although other studies show that there were no such differences. The aim of the present study was to assess differences in the prevalence of hospitalizations and in-hospital outcomes between the sexes, using a larger administrative database.
Methods: We used the 2020 California State Inpatient Database for this retrospective analysis. International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code U07.1 was used to identify COVID-19 hospitalizations. These hospitalizations were subsequently stratified by male and female sex. Diagnosis and procedures were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. The primary outcome of the study was hospitalization rate, and secondary outcomes were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and intensive care unit (ICU) admission.
Results: There were 95,180 COVID-19 hospitalizations among patients 18 years and older, 52,465 (55.1%) of which were among men and 42,715 (44.9%) were among women. In-hospital mortality (12.4% vs 10.1%), prolonged length of hospital stays (30.6% vs 25.8%), vasopressor use (2.6% vs 1.6%), mechanical ventilation (11.8% vs 8.0%), and ICU admission rates (11.4% versus 7.8%) were significantly higher among male compared with female hospitalizations. Conditional logistic regression analysis showed that the odds of mortality (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.38-1.44), hospital lengths of stay (OR 1.35, 95% CI 1.31-1.39), vasopressor use (OR 1.59, 95% CI 1.51-1.66), mechanical ventilation (OR 1.62, 95% CI 1.47-1.78), and ICU admission rates (OR 1.58, 95% CI 1.51-1.66) were significantly higher among male hospitalizations.
Conclusion: Our findings show that male sex is an independent and strong risk factor associated with COVID-19 severity.
期刊介绍：
As the official journal of the Birmingham, Alabama-based Southern Medical Association (SMA), the Southern Medical Journal (SMJ) has for more than 100 years provided the latest clinical information in areas that affect patients'' daily lives. Now delivered to individuals exclusively online, the SMJ has a multidisciplinary focus that covers a broad range of topics relevant to physicians and other healthcare specialists in all relevant aspects of the profession, including medicine and medical specialties, surgery and surgery specialties; child and maternal health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices. Each month, articles span the spectrum of medical topics, providing timely, up-to-the-minute information for both primary care physicians and specialists. Contributors include leaders in the healthcare field from across the country and around the world. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.
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