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PLoS One . Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARS-RAS study of the Ita

tetano

Editor, Senior Moderator
PLoS One


. 2020 Oct 6;15(10):e0237297.
doi: 10.1371/journal.pone.0237297. eCollection 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


Guido Iaccarino[SUP] 1 [/SUP], Guido Grassi[SUP] 2 [/SUP], Claudio Borghi[SUP] 3 [/SUP], Stefano Carugo[SUP] 4 [/SUP], Francesco Fallo[SUP] 5 [/SUP], Claudio Ferri[SUP] 6 [/SUP], Cristina Giannattasio[SUP] 7 [/SUP], Davide Grassi[SUP] 6 [/SUP], Claudio Letizia[SUP] 8 [/SUP], Costantino Mancusi[SUP] 1 [/SUP], Pietro Minuz[SUP] 9 [/SUP], Stefano Perlini[SUP] 10 [/SUP], Giacomo Pucci[SUP] 11 [/SUP], Damiano Rizzoni[SUP] 12 [/SUP], Massimo Salvetti[SUP] 13 [/SUP], Riccardo Sarzani[SUP] 14 [/SUP], Leonardo Sechi[SUP] 15 [/SUP], Franco Veglio[SUP] 16 [/SUP], Massimo Volpe[SUP] 17 [/SUP], Maria Lorenza Muiesan[SUP] 13 [/SUP], SARS-RAS Investigators



Affiliations

Abstract

Background: The global rate of intensive care unit (ICU) admission during the COVID-19 pandemic varies within countries and is among the main challenges for health care systems worldwide. Conflicting results have been reported about the response to coronavirus infection and COVID-19 outcomes in men and women. Understanding predictors of intensive care unit admission might be of help for future planning and management of the disease.
Methods and findings: We designed a cross-sectional observational multicenter nationwide survey in Italy to understand gender-related clinical predictors of ICU admission in patients with COVID-19. We analyzed information from 2378 charts of Italian patients certified for COVID-19 admitted in 26 hospitals. Three hundred ninety-five patients (16.6%) required ICU admission due to COVID19 infection, more frequently men (74%), with a higher prevalence of comorbidities (1,78?0,06 vs 1,54?0,03 p<0.05). In multivariable regression model main predictors of admission to ICU are male gender (OR 1,74 95% CI 1,36-2,22 p<0.0001) and presence of obesity (OR 2,88 95% CI 2,03-4,07 p<0.0001), chronic kidney disease (OR: 1,588; 95%, 1,036-2,434 p<0,05) and hypertension (OR: 1,314; 95% 1,039-1,662; p<0,05). In gender specific analysis, obesity, chronic kidney disease and hypertension are associated with higher rate of admission to ICU among men, whereas in women, obesity (OR: 2,564; 95% CI 1,336-4.920 p<0.0001) and heart failure (OR: 1,775 95% CI: 1,030-3,057) are associated with higher rate of ICU admission.
Conclusions: Our study demonstrates that gender is the primary determinant of the disease's severity among COVID-19. Obesity is the condition more often observed among those admitted to ICU within both genders.
 
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