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Sex Differences in the Incidence and Risk Factors of Myocardial Injury in COVID-19 Patients: A Retrospective Cohort Study

Male novel coronavirus disease (COVID-19) patients tend to have poorer clinical outcomes than female patients, while the myocardial injury is strongly associated with COVID-19-related adverse events. Owing to a lack of corresponding data, we aimed to investigate the sex differences in the incidence...

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Autores principales: Cheng, Ran, Liu, Chuan, Yang, Jie, Yang, Yuanqi, Chen, Renzheng, Ding, Xiaohan, Gao, Xubin, Ke, Jingbin, Yuan, Fangzhengyuan, He, Chunyan, Shen, Yang, Zhang, Limin, Li, Ping, Tan, Hu, Huang, Lan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920972/
https://www.ncbi.nlm.nih.gov/pubmed/33664674
http://dx.doi.org/10.3389/fphys.2021.632123
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author Cheng, Ran
Liu, Chuan
Yang, Jie
Yang, Yuanqi
Chen, Renzheng
Ding, Xiaohan
Gao, Xubin
Ke, Jingbin
Yuan, Fangzhengyuan
He, Chunyan
Shen, Yang
Zhang, Limin
Li, Ping
Tan, Hu
Huang, Lan
author_facet Cheng, Ran
Liu, Chuan
Yang, Jie
Yang, Yuanqi
Chen, Renzheng
Ding, Xiaohan
Gao, Xubin
Ke, Jingbin
Yuan, Fangzhengyuan
He, Chunyan
Shen, Yang
Zhang, Limin
Li, Ping
Tan, Hu
Huang, Lan
author_sort Cheng, Ran
collection PubMed
description Male novel coronavirus disease (COVID-19) patients tend to have poorer clinical outcomes than female patients, while the myocardial injury is strongly associated with COVID-19-related adverse events. Owing to a lack of corresponding data, we aimed to investigate the sex differences in the incidence of myocardial injury in COVID-19 patients and to identify the potential underlying mechanisms, which may partly account for the sex bias in the incidence of adverse events. This retrospective study included 1,157 COVID-19 patients who were hospitalized in Huoshenshan Hospital from 12 March 2020 to 11 April 2020. Data on the patients’ demographic characteristics, initial symptoms, comorbidities and laboratory tests were collected. Totally, 571 (49.4%) female and 586 (50.6%) male COVID-19 patients were enrolled. The incidence of myocardial injury was higher among men than women (9.2 vs. 4.9%, p = 0.004). In the logistic regression analysis, age, and chronic kidney disease were associated with myocardial injury in both sexes. However, hypertension [odds ratio (OR) = 2.25, 95% confidence interval (CI) 1.20–4.22], coronary artery disease (OR = 2.46, 95% CI 1.14–5.34), leucocyte counts (OR = 3.13, 95% CI 1.24–7.86), hs-CRP (OR = 4.45, 95% CI 1.33–14.83), and D-dimer [OR = 3.93 (1.27–12.19), 95% CI 1.27–12.19] were independent risk factors only in the men. The correlations of hs-CRP and D-dimer with hs-cTnI and BNP were stronger in the men. The incidence of myocardial injury in COVID-19 patients is sex-dependent, predominantly in association with a greater degree of inflammation and coagulation disorders in men. Our findings can be used to improve the quality of clinical management in such settings.
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spelling pubmed-79209722021-03-03 Sex Differences in the Incidence and Risk Factors of Myocardial Injury in COVID-19 Patients: A Retrospective Cohort Study Cheng, Ran Liu, Chuan Yang, Jie Yang, Yuanqi Chen, Renzheng Ding, Xiaohan Gao, Xubin Ke, Jingbin Yuan, Fangzhengyuan He, Chunyan Shen, Yang Zhang, Limin Li, Ping Tan, Hu Huang, Lan Front Physiol Physiology Male novel coronavirus disease (COVID-19) patients tend to have poorer clinical outcomes than female patients, while the myocardial injury is strongly associated with COVID-19-related adverse events. Owing to a lack of corresponding data, we aimed to investigate the sex differences in the incidence of myocardial injury in COVID-19 patients and to identify the potential underlying mechanisms, which may partly account for the sex bias in the incidence of adverse events. This retrospective study included 1,157 COVID-19 patients who were hospitalized in Huoshenshan Hospital from 12 March 2020 to 11 April 2020. Data on the patients’ demographic characteristics, initial symptoms, comorbidities and laboratory tests were collected. Totally, 571 (49.4%) female and 586 (50.6%) male COVID-19 patients were enrolled. The incidence of myocardial injury was higher among men than women (9.2 vs. 4.9%, p = 0.004). In the logistic regression analysis, age, and chronic kidney disease were associated with myocardial injury in both sexes. However, hypertension [odds ratio (OR) = 2.25, 95% confidence interval (CI) 1.20–4.22], coronary artery disease (OR = 2.46, 95% CI 1.14–5.34), leucocyte counts (OR = 3.13, 95% CI 1.24–7.86), hs-CRP (OR = 4.45, 95% CI 1.33–14.83), and D-dimer [OR = 3.93 (1.27–12.19), 95% CI 1.27–12.19] were independent risk factors only in the men. The correlations of hs-CRP and D-dimer with hs-cTnI and BNP were stronger in the men. The incidence of myocardial injury in COVID-19 patients is sex-dependent, predominantly in association with a greater degree of inflammation and coagulation disorders in men. Our findings can be used to improve the quality of clinical management in such settings. Frontiers Media S.A. 2021-02-16 /pmc/articles/PMC7920972/ /pubmed/33664674 http://dx.doi.org/10.3389/fphys.2021.632123 Text en Copyright © 2021 Cheng, Liu, Yang, Yang, Chen, Ding, Gao, Ke, Yuan, He, Shen, Zhang, Li, Tan and Huang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Cheng, Ran
Liu, Chuan
Yang, Jie
Yang, Yuanqi
Chen, Renzheng
Ding, Xiaohan
Gao, Xubin
Ke, Jingbin
Yuan, Fangzhengyuan
He, Chunyan
Shen, Yang
Zhang, Limin
Li, Ping
Tan, Hu
Huang, Lan
Sex Differences in the Incidence and Risk Factors of Myocardial Injury in COVID-19 Patients: A Retrospective Cohort Study
title Sex Differences in the Incidence and Risk Factors of Myocardial Injury in COVID-19 Patients: A Retrospective Cohort Study
title_full Sex Differences in the Incidence and Risk Factors of Myocardial Injury in COVID-19 Patients: A Retrospective Cohort Study
title_fullStr Sex Differences in the Incidence and Risk Factors of Myocardial Injury in COVID-19 Patients: A Retrospective Cohort Study
title_full_unstemmed Sex Differences in the Incidence and Risk Factors of Myocardial Injury in COVID-19 Patients: A Retrospective Cohort Study
title_short Sex Differences in the Incidence and Risk Factors of Myocardial Injury in COVID-19 Patients: A Retrospective Cohort Study
title_sort sex differences in the incidence and risk factors of myocardial injury in covid-19 patients: a retrospective cohort study
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920972/
https://www.ncbi.nlm.nih.gov/pubmed/33664674
http://dx.doi.org/10.3389/fphys.2021.632123
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