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BMC Cardiovasc Disord . Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 1

tetano

Editor, Senior Moderator
BMC Cardiovasc Disord


. 2025 Mar 5;25(1):147.
doi: 10.1186/s12872-025-04565-3. Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19-20 registry

Frank Cañón-Estrada[SUP] 1 [/SUP], Juan Andrés Muñoz-Ordoñez[SUP] 1 [/SUP], Manuela Escalante-Forero[SUP] 1 [/SUP], Yorlany Rodas[SUP] 2 [/SUP], Andrea Alejandra Arteaga-Tobar[SUP] 1 [/SUP], Valeria Azcarate-Rodriguez[SUP] 1 [/SUP], Eduardo Perna[SUP] 3 [/SUP], Iván Mendoza[SUP] 4 [/SUP], Fernando Wyss[SUP] 5 [/SUP], José Luis Barisani[SUP] 6 [/SUP], Mario Speranza[SUP] 7 [/SUP], Walter Alarco[SUP] 8 [/SUP], Juan Carlos Ortega[SUP] 9 [/SUP], Andrés Ulate[SUP] 10 [/SUP], Jessica Mercedes[SUP] 11 [/SUP], Daniel Quesada Chaves[SUP] 12 [/SUP], Paola Oliver[SUP] 13 [/SUP], Andrea Valencia-Orozco[SUP] 2 [/SUP], Mario Miguel Barbosa[SUP] 2 [/SUP], Hoover León-Giraldo[SUP] 2 [/SUP], Noel Alberto Flórez[SUP] 14 [/SUP], Juan Esteban Gómez-Mesa[SUP] 15 16 17 [/SUP]; CARDIO COVID 19-20 Research Group



Collaborators, Affiliations
Abstract

Background: The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex.
Objective: To compare clinical data, biochemical biomarkers, and outcomes among hospitalized COVID-19 patients in Latin America and the Caribbean (LA&C) based on sex and to perform a cluster analysis of biomarker profiles for both sexes.
Methods: This prospective, multicenter observational registry made by the Inter-American Council of Heart Failure and Pulmonary Hypertension of the Inter-American Society of Cardiology included hospitalized COVID-19 patients from 44 hospitals in 14 countries in LA&C between May 1, 2020, and June 30, 2021.
Results: Of 3,260 patients (1,201 females and 2,059 males), males had higher C-reactive protein and ferritin levels, while females had higher natriuretic peptides and d-dimer levels. Males had more cardiovascular complications (acute coronary syndrome [3.3% vs. 2.2%], decompensated heart failure [8.9% vs. 7.8%], pulmonary embolism [4.4% vs. 2.9%]), intensive care unit (ICU) admissions (56.9% vs. 47.7%), and overall mortality (27.5% vs. 22.1%). Cluster analysis identified three groups: one with normal-range biomarkers but elevated ferritin, one with coagulation abnormalities, and one with an inflammatory profile linked to renal injury and increased non-cardiovascular mortality.
Conclusions: In the LA&C population hospitalized with COVID-19, males had higher inflammatory biomarker levels, correlating with increased cardiovascular complications and mortality. The cluster with an inflammatory profile showed higher non-cardiovascular mortality, while clusters with elevated ferritin levels were associated with increased ICU admissions.

Keywords: Biomarkers; COVID-19; Cardiovascular complications; Latin America; Sex factors.

 
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