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Volume 18
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Article

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

by
Nicolás Francisco Fernández-Martínez
1,2,
Rocío Ortiz-González-Serna
1,2,
Álvaro Serrano-Ortiz
1,2,
Mario Rivera-Izquierdo
3,4,5,
Rafael Ruiz-Montero
1,2,6,*,
Marina Pérez-Contreras
7,
Inmaculada Guerrero-Fernández de Alba
3,8,
Álvaro Romero-Duarte
9 and
Inmaculada Salcedo-Leal
1,2,6
1
Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
2
Preventive Medicine and Public Health Research Group, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), 14004 Córdoba, Spain
3
Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
4
Instituto de Investigación Biosanitaria, ibs. Granada, 18012 Granada, Spain
5
Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
6
Facultad de Medicina y Enfermería, Universidad de Córdoba, 14004 Córdoba, Spain
7
Service of Preventive Medicine and Public Health, Hospital Universitario de Puerto Real, 11510 Puerto Real, Spain
8
Service of Preventive Medicine and Public Health, Complejo Hospitalario de Jaén, 23007 Jaén, Spain
9
School of Medicine, University of Granada, 18016 Granada, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(17), 9018; https://doi.org/10.3390/ijerph18179018
Submission received: 1 July 2021 / Revised: 6 August 2021 / Accepted: 17 August 2021 / Published: 26 August 2021
(This article belongs to the Special Issue COVID-19: Prognosis, Outcomes and Long-Term Sequelae)
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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 COVID-19; SARS-CoV-2; hospital mortality; risk factors; sex

Share and Cite

MDPI and ACS Style

Fernández-Martínez, N.F.; Ortiz-González-Serna, R.; Serrano-Ortiz, Á.; Rivera-Izquierdo, M.; Ruiz-Montero, R.; Pérez-Contreras, M.; Guerrero-Fernández de Alba, I.; Romero-Duarte, Á.; Salcedo-Leal, I. Sex Differences and Predictors of In-Hospital Mortality among Patients with COVID-19: Results from the ANCOHVID Multicentre Study. Int. J. Environ. Res. Public Health 2021, 18, 9018. https://doi.org/10.3390/ijerph18179018

AMA Style

Fernández-Martínez NF, Ortiz-González-Serna R, Serrano-Ortiz Á, Rivera-Izquierdo M, Ruiz-Montero R, Pérez-Contreras M, Guerrero-Fernández de Alba I, Romero-Duarte Á, Salcedo-Leal I. Sex Differences and Predictors of In-Hospital Mortality among Patients with COVID-19: Results from the ANCOHVID Multicentre Study. International Journal of Environmental Research and Public Health. 2021; 18(17):9018. https://doi.org/10.3390/ijerph18179018

Chicago/Turabian Style

Fernández-Martínez, Nicolás Francisco, 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. 2021. "Sex Differences and Predictors of In-Hospital Mortality among Patients with COVID-19: Results from the ANCOHVID Multicentre Study" International Journal of Environmental Research and Public Health 18, no. 17: 9018. https://doi.org/10.3390/ijerph18179018

APA Style

Fernández-Martínez, N. F., Ortiz-González-Serna, R., Serrano-Ortiz, Á., Rivera-Izquierdo, M., Ruiz-Montero, R., Pérez-Contreras, M., Guerrero-Fernández de Alba, I., Romero-Duarte, Á., & Salcedo-Leal, I. (2021). Sex Differences and Predictors of In-Hospital Mortality among Patients with COVID-19: Results from the ANCOHVID Multicentre Study. International Journal of Environmental Research and Public Health, 18(17), 9018. https://doi.org/10.3390/ijerph18179018

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