Sex-Based Differences in Outcomes of Coronavirus Disease 2019 (COVID-19) in Korea

PURPOSE: This study examined the factors affecting mortality and clinical severity score (CSS) of male and female patients with Coronavirus Disease 2019 (COVID-19) using clinical epidemiological information provided by the Korea Disease Control and Prevention Agency. METHODS: This is a retrospective, observational cohort study. From January 21 to April 30, 2020, a total of 5624 patients who were released from quarantine or died were analyzed. RESULTS: The factors influencing release or death that differed by sex were high heart rate and malignancy in males and chronic kidney disease in females. In addition, the factors influencing progression to severe CSS were high BMI (severe obesity) and rheumatic disease in males and high temperature, sputum production, absence of sore throat and headache, chronic kidney disease, malignancy, and chronic liver disease in females. Older age, low lymphocyte count and platelets, dyspnea, diabetes mellitus, dementia, and intensive care unit (ICU) admission affected mortality in all the patients, and older age, low lymphocyte count and platelets, fever, dyspnea, diabetes mellitus, dementia, and ICU admission affected progression to severe stage of CSS. CONCLUSIONS: This study is expected to contribute to the general results by analyzing nationally representative data. The results of this study present an important basis for development of differentiated nursing and medical management strategies in consideration of factors that influence treatment effects and outcomes according to sex of patients with COVID-19.