Sex Differences and Predictors of In-Hospital Mortality among Patients with COVID-19: Results from the ANCOHVID Multicentre Study

Nicolás Francisco Fernández-Martínez, Rocío Ortiz-González-Serna, Álvaro Serrano-Ortiz, Mario Rivera-Izquierdo, Rafael Ruiz-Montero, Marina Pérez-Contreras, Inmaculada Guerrero-Fernández de Alba, Álvaro Romero-Duarte and Inmaculada Salcedo-Leal
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Nicolás Francisco Fernández-Martínez: Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
Rocío Ortiz-González-Serna: Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
Álvaro Serrano-Ortiz: Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
Mario Rivera-Izquierdo: Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
Rafael Ruiz-Montero: Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
Marina Pérez-Contreras: Service of Preventive Medicine and Public Health, Hospital Universitario de Puerto Real, 11510 Puerto Real, Spain
Inmaculada Guerrero-Fernández de Alba: Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
Álvaro Romero-Duarte: School of Medicine, University of Granada, 18016 Granada, Spain
Inmaculada Salcedo-Leal: Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain

IJERPH, 2021, vol. 18, issue 17, 1-16

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.

Keywords: COVID-19; SARS-CoV-2; hospital mortality; risk factors; sex (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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