INVESTIGATION OF THE EFFECT OF GENDER ON LABORATORY PARAMETERS AND LENGTH OF HOSPITAL STAY IN HOSPITALIZED COVID-19 PATIENTS: A RETROSPECTIVE STUDY
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COVID-19, gender, length of stay, SARS-CoV-2Abstract
The aim of this study is to retrospectively compare the demographic data, biochemical parameters, and length of hospital stay of patients hospitalized due to COVID-19 according to gender, and to determine the effect of gender on the COVID-19. A total of 191 COVID-19 patients who were hospitalized and treated in the hospital were included in the study. Statistical analyses of the data were performed using Jamovi V. 1.8.1 software. The distribution of the data was checked for homogeneity with the Levene test, and the WBC and day parameters were tested using the Mann Whitney-U test, while other parameters were tested with t-test in independent variables. p<0.05 was considered statistically significant. According to the results of our study, the average age of male patients was found to be 64.58+14.52, while the average age of female patients was found to be 70.72+12.74. Statistically significant differences were found between male and female COVID-19 patients in terms of hemoglobin, monocyte count, and length of hospital stay, except for the age parameter. No differences were found in other biochemical or inflammatory parameters examined, such as D-dimer, AST, ALT, or CRP. In female patients, hemoglobin levels, monocyte levels, and length of hospital stay were lower compared to males. The average length of hospital stay was 7.55 days in males and 7.45 days in females. Our retrospective analysis revealed that gender differences have an impact on COVID-19. We believe it is necessary to further explore the impact of gender on COVID-19 infection to better understand how to address this public health issue.
References
El Aidaoui, K., Benhamou, R. A., Haoudar, A., Ziati, J., Kantri, A., Agrad, K., El Kettani, C. (2022): Sex differences in COVID-19 outcomes. Cureus 14(6).
Abbasifard, M., Arababadi, M. K., Bahrehmand, F., Bazmandegan, G., Shahrbabaki, Z. S., Kamiab, Z. (2022): Gender affects IL-23 serum levels in the hospitalized COVID-19 infected patients. American Journal of Clinical and Experimental Immunology 11(2): 28.
Paschou, S. A., Psaltopoulou, T., Halvatsiotis, P., Raptis, A., Vlachopoulos, C. V., Dimopoulos, M. A. (2022): Gender differences in COVID-19. Maturitas 161, 72.
Scottish Diabetes Research Network Epidemiology Group. (2020): Risks of and risk factors for COVID-19 disease in people with diabetes: a cohort study of the total population of Scotland. The Lancet Diabetes & Endocrinology.
Schurz, H., Salie, M., Tromp, G., Hoal, E. G., Kinnear, C. J., & Möller, M. (2019): The X chromosome and sex-specific effects in infectious disease susceptibility. Human Genomics 13: 1-12.
Sund, M., Fonseca-Rodríguez, O., Josefsson, A., Welen, K., & Connolly, A. M. F. (2022): Association between pharmaceutical modulation of oestrogen in postmenopausal women in Sweden and death due to COVID-19: a cohort study. BMJ Open 12(2): e053032.
Ranieri, V. M., Rubenfeld, G. D., Taylor Thompson, B., Ferguson, N. D., Caldwell, E., Fan, E., Slutsky, A. S. (2012): Acute respiratory distress syndrome: the Berlin Definition. JAMA: Journal of the American Medical Association 307: (23).
Robinson, D. P., Lorenzo, M. E., Jian, W., & Klein, S. L. (2011): Elevated 17β-estradiol protects females from influenza A virus pathogenesis by suppressing inflammatory responses. PLoS Pathogens 7(7): e1002149.
Qian, J., Zhao, L., Ye, R. Z., Li, X. J., & Liu, Y. L. (2020): Age-dependent gender differences in COVID-19 in Mainland China: Comparative study. Clinical Infectious Diseases 71(9): 2488-2494
Burki, T. (2020): The indirect impact of COVID-19 on women. The Lancet infectious diseases 20(8): 904-905.
Dehingia, N., & Raj, A. (2021): Sex differences in COVID-19 case fatality: do we know enough?. The Lancet Global Health 9(1): e14-e15.
Peckham, H., de Gruijter, N. M., Raine, C., Radziszewska, A., Ciurtin, C., Wedderburn, L. R., Deakin, C. T. (2020): Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nature Communications 11(1): 6317.
Spagnolo, P. A., Manson, J. E., & Joffe, H. (2020): Sex and gender differences in health: what the COVID-19 pandemic can teach us. Annals of Internal Medicine 173(5): 385-386.
Takahashi, T., & Iwasaki, A. (2021): Sex differences in immune responses. Science 371(6527): 347-348.
Galasso, V., Pons, V., Profeta, P., Becher, M., Brouard, S., & Foucault, M. (2020): Gender differences in COVID-19 attitudes and behavior: Panel evidence from eight countries. Proceedings of the National Academy of Sciences 117(44): 27285-27291.
Tadiri, C. P., Gisinger, T., Kautzky-Willer, A., Kublickiene, K., Herrero, M. T., Raparelli, V., Norris, C. M. (2020): The influence of sex and gender domains on COVID-19 cases and mortality. Cmaj 192(36): E1041-E1045.
Abate, B. B., Kassie, A. M., Kassaw, M. W., Aragie, T. G., & Masresha, S. A. (2020): Sex difference in coronavirus disease (COVID-19): a systematic review and meta-analysis. BMJ Open 10(10): e040129.
Ding, T., Zhang, J., Wang, T., Cui, P., Chen, Z., Jiang, J., ...& Wang, S. (2021): Potential influence of menstrual status and sex hormones on female severe acute respiratory syndrome coronavirus 2 infection: a cross-sectional multicenter study in Wuhan, China. Clinical Infectious Diseases 72(9): e240-e248.
Karlberg, J., Chong, D. S. Y., Lai, W. Y. Y. (2004): Do men have a higher case fatality rate of severe acute respiratory syndrome than women do? American Journal of Epidemiology 159(3): 229-231.
Raparelli, V., Palmieri, L., Canevelli, M., Pricci, F., Unim, B., Lo Noce, C., Onder, G. (2020): Sex differences in clinical phenotype and transitions of care among individuals dying of COVID-19 in Italy. Biology of Sex Differences 11: 1-9.
Su, W., Qiu, Z., Zhou, L., Hou, J., Wang, Y., Huang, F., Lei, S. (2020): Sex differences in clinical characteristics and risk factors for mortality among severe patients with COVID-19: a retrospective study. Aging (Albany NY) 12(19): 18833.
Iaccarino, G., Grassi, G., Borghi, C., Carugo, S., Fallo, F., Ferri, C., SARS-RAS Investigators. (2020): Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARS-RAS study of the Italian Society of Hypertension. PLoS One 15(10): e0237297.
Trifan, G., Goldenberg, F. D., Caprio, F. Z., Biller, J., Schneck, M., Khaja, A., Testai, F. D. (2020). Characteristics of a diverse cohort of stroke patients with SARS-CoV-2 and outcome by sex. Journal of Stroke and Cerebrovascular Diseases 29(11): 105314.
Klang, E., Soffer, S., Nadkarni, G., Glicksberg, B., Freeman, R., Horowitz, C., Levin, M. A. (2020): Sex differences in age and comorbidities for COVID-19 mortality in urban New York City. SN Comprehensive Clinical Medicine 2: 1319-1322.
Chen, J., Bai, H., Liu, J., Chen, G., Liao, Q., Yang, J., Li, K. (2020): Distinct clinical characteristics and risk factors for mortality in female COVID-19 inpatients: a sex-stratified large-scale cohort study in Wuhan, China. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America.
Hampton, T. (2020): Insight on sex-based immunity differences, with COVID-19 implications. JAMA 324(13): 1274-1274.
Haitao, T., Vermunt, J. V., Abeykoon, J., Ghamrawi, R., Gunaratne, M., Jayachandran, M., Garovic, V. D. (2020): COVID-19 and sex differences: mechanisms and biomarkers. In Mayo Clinic Proceedings (Vol. 95, No. 10, pp. 2189-2203). Elsevier.
Tsilidis, K. K., Rohrmann, S., McGlynn, K. A., Nyante, S. J., Lopez, D. S., Bradwin, G., Platz, E. A. (2013): Association between endogenous sex steroid hormones and inflammatory biomarkers in US men. Andrology 1(6): 919-928.
Straub, R. H. (2007): The complex role of estrogens in inflammation. Endocrine Reviews 28(5): 521-574.
Giefing‐Kröll, C., Berger, P., Lepperdinger, G., Grubeck‐Loebenstein, B. (2015): How sex and age affect immune responses, susceptibility to infections, and response to vaccination. Aging Cell 14(3): 309-321.
Hel, Z., Stringer, E., & Mestecky, J. (2010): Sex steroid hormones, hormonal contraception, and the immunobiology of human immunodeficiency virus-1 infection. Endocrine Reviews 31(1): 79-97.
Tay, M. Z., Poh, C. M., Rénia, L., MacAry, P. A., & Ng, L. F. (2020): The trinity of COVID-19: immunity, inflammation and intervention. Nature Reviews Immunology 20(6): 363-374.
Ng, S. C., & Tilg, H. (2020): COVID-19 and the gastrointestinal tract: more than meets the eye. Gut, 69(6): 973-974.
Feng G, Zheng KI, Yan QQ, Rios RS, Targher G, Byrne CD, et al. (2020): COVID-19 and liver dysfunction: current insights and emergent therapeutic strategies. J Clin Transl Hepatol 8(1):18–24.
Ronco, C., Reis, T., & Husain-Syed, F. (2020): Management of acute kidney injury in patients with COVID-19. The Lancet Respiratory Medicine 8(7), 738-742.
Zheng, Y. Y., Ma, Y. T., Zhang, J. Y., & Xie, X. (2020): COVID-19 and the cardiovascular system. Nature Reviews Cardiology 17(5): 259-260.
Dudley, J. P., & Lee, N. T. (2020). Disparities in age-specific morbidity and mortality from SARS-CoV-2 in China and the Republic of Korea. Clinical Infectious Diseases 71(15): 863-865.
Ten-Caten, F., Gonzalez-Dias, P., Castro, Í., Ogava, R. L., Giddaluru, J., Silva, J. C. S., Nakaya, H. I. (2021): In-depth analysis of laboratory parameters reveals the interplay between sex, age, and systemic inflammation in individuals with COVID-19. International Journal of Infectious Diseases 105: 579-587.
Scully, E. P., Haverfield, J., Ursin, R. L., Tannenbaum, C., Klein, S. L. (2020): Considering how biological sex impacts immune responses and COVID-19 outcomes. Nature Reviews Immunology, 20(7): 442-447.
Michelozzi, P., de’Donato, F., Scortichini, M., De Sario, M., Noccioli, F., Rossi, P., & Davoli, M. (2020). Mortality impacts of the coronavirus disease (COVID-19) outbreak by sex and age: rapid mortality surveillance system, Italy, 1 February to 18 April 2020. Eurosurveillance 25(19): 2000620.
Risitano, A. M., Mastellos, D. C., Huber-Lang, M., Yancopoulou, D., Garlanda, C., Ciceri, F., & Lambris, J. D. (2020): Complement as a target in COVID-19?. Nature Reviews Immunology 20(6): 343-344.
Arachchillage, D. R., & Laffan, M. (2020): Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis 18(5): 1233.
Bomhof, G., Mutsaers, P. G., Leebeek, F. W., Te Boekhorst, P. A., Hofland, J., Croles, F. N., Jansen, A. G. (2020): COVID‐19‐associated immune thrombocytopenia. British Journal of Haematology 190(2): e61.
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Cao, B. (2020): Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet 395(10229): 1054-1062.
Samarasinghe, A. E., Melo, R. C., Duan, S., LeMessurier, K. S., Liedmann, S., Surman, S. L., McCullers, J. A. (2017): Eosinophils promote antiviral immunity in mice infected with influenza A virus. The Journal of Immunology 198(8): 3214-3226.
Kadel, S., & Kovats, S. (2018): Sex hormones regulate innate immune cells and promote sex differences in respiratory virus infection. Frontiers in Immunology 9: 1653.
Li, Q., Ding, X., Xia, G., Chen, H. G., Chen, F., Geng, Z., Wang, Z. (2020): Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: a retrospective case-control study. EClinicalMedicine 23.
Gebhard, C., Regitz-Zagrosek, V., Neuhauser, H. K., Morgan, R., & Klein, S. L. (2020): Impact of sex and gender on COVID-19 outcomes in Europe. Biology of Sex Differences 11: 1-13.
Meng, Y., Wu, P., Lu, W., Liu, K., Ma, K., Huang, L., Wu, P. (2020): Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: A retrospective study of 168 severe patients. PLoS Pathogens 16(4): e1008520.
Vahidy, F. S., Pan, A. P., Ahnstedt, H., Munshi, Y., Choi, H. A., Tiruneh, Y., McCullough, L. D. (2021): Sex differences in susceptibility, severity, and outcomes of coronavirus disease 2019: Cross-sectional analysis from a diverse US metropolitan area. PloS One 16(1): e0245556.
Guan, W. J., Liang, W. H., Zhao, Y., Liang, H. R., Chen, Z. S., Li, Y. M., He, J. X. (2020): Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. European Respiratory Journal 55(5).
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