Gender differences in correlation of biochemical parameters with the severity of COVID pneumonia and the need for oxygen/mechanical support

Gender differences in biochemical parameters in COVID pneumonia

  • Jelena Janković Clinic for Pulmonology, University Clinical Center of Serbia
  • Mihailo Stjepanovic Clinic for Pulmonology, University Clinical Center of Serbia
  • Nikola Maric Clinic for Pulmonology, University Clinical Center of Serbia
  • Slobodan Belic Clinic for Pulmonology, University Clinical Center of Serbia
Keywords: COVID-19, gender, biochemical results, mechanical ventilation, oxygen therapy

Abstract


Background:COVID-19 pandemic had caused a global medical, economic and social problems. High infection rate, heterogenous presentation, lack of previous data and no standardized treatment had led to a need for further analysis, in order to be prepared for any potential new pandemics. We analyzed any possible correlation between gender, laboratory findings and severity of disease with need for oxygen or mechanical ventilation support.  

Methods: 100 patients with confirmed SARS-CoV-2 virus infection enrolled. Baseline characteristics that included age, sex, smoking history, BMI, oxygen therapy or mechanical ventilation support need were recorded. Type and severity of radiological finding determined by chest CT scan.

Results: Majority of our patients were over 61 years old (58.6%), male (57.6%), and had severe radiological finding (bilateral pneumonia 29.3%, ARDS 35.4%), with only 20.2% had not required any oxygen supplementation. Regarding gender and laboratory findings, men have shown statistically significant higher values of CRP, lymphocytes, LDH and ferritin (96.4 vs 87.1, p=0.014; 1.17 vs 0.84, p=0.048; 674.8 vs 609.1, p=0.031; 1263 vs 578.4, p=0.001, respectfully). Severe radiological finding had shown positive correlation with the need for HFNC and/or (N)IMV (p=0.021 and p=0.032. respectfully), as well as with higher values of WBC, LDH and ferritin (p=0.042, p=0.035 and p=0.017. respectfully).

Conclusions: There is a difference between presentation of the disease, as well as analyzed laboratory markers between sexes. The difference is most likely multifactorial and should require further research in order to discover other risk and prognostic factors.

References

REFERENCES
1. Statement on the fourteenth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic. Available at https://www.who.int/news/item/30-01- 2023-statement-on-the-fourteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic.
2. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-733
3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395 (10223): 497–506.
4. Thomas Craig KJ, Rizvi R, Willis VC, Kassler WJ, Jackson GP. Effectiveness of Contact Tracing for Viral Disease Mitigation and Suppression: Evidence-Based Review. JMIR Public Health Surveill 2021; 7: e32468.
5. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–1242
6. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020;395(10229): 1033–4.
7. Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet 2020;395:1763–70.
8. Letelier P Encina N, Morales P, Riffo A, Silva H, Riquelme I, Guzmán N. Role of biochemical markers in the monitoring of COVID-19 patients. J Med Biochem 2021; 40 (2) 115–28.
9. Tomar B, Anders H-J, Desai J, Mulay SR. Neutrophils and neutrophil extracellular traps drive necroinflammation in COVID-19. Cells 2020; 9: 1383.
10. World Health Organization. SUBJECT IN FOCUS: WHO Global Case-Based Surveillance for Human Infection with Coronavirus Disease (COVID-19).; 2020. Accessed May 23, 2020 at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200418-sitrep-89-covid-19.pdf?sfvrsn=3643dd38_2
11. Amgalan A, Malinowski AK, Othman M. COVID-19 and Sex-/Gender-Specific Differences: Understanding the Discrimination. Semin Thromb Hemost. 2021 Jun;47(4):341-347.
12. COVID-19 sex-disaggregated data tracker – Global Health 50/50. Accessed May 23, 2020 at: https://globalhealth5050.org/covid19/sex-disaggregated-data-tracker/#1587645651236-8a62beb3-4a03
13. Walter LA, McGregor AJ. Sex- and gender-specific observations and implications for COVID-19. West J Emerg Med 2020; 21 (03) 507-509
14. Hewagama A, Patel D, Yarlagadda S, Strickland FM, Richardson BC. Stronger inflammatory/cytotoxic T-cell response in women identified by microarray analysis. Genes Immun 2009; 10 (05) 509-516
15. Moulton VR. Sex hormones in acquired immunity and autoimmune disease. Front Immunol 2018; 9: 2279
16. Matsuyama S, Nao N, Shirato K. et al. Enhanced isolation of SARS-CoV-2 by TMPRSS2-expressing cells. Proc Natl Acad Sci U S A 2020; 117 (13) 7001-7003
17. Meng Y., Wu P., Lu W. Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: a retrospective study of 168 severe patients. PLoS Pathog. 2020;16(4):e1008520.
18. Zhang J, Dong X, Cao Y, Yuan Y, Yang Y, Yan Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Eur J Allergy Clin Immunol 2020; 75: 1730–41.
19. Huang I., Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care. 2020;8:36.
20. Ahnach M, Zbiri S, Nejjari S, Austin F, Elkettani C. C-reactive protein as an early predictor of COVID-19 severity. J Med Biochem. 2020;39:500–7
21. Luo W, Zhang JW, Zhang W, Lin YL, Wang Q. Circulating levels of IL-2, IL-4, TNF-alpha, IFN-gamma, and C-reactive protein are not associated with severity of COVID-19 symptoms. J Med Virol. 2021;93:89–91
22. Kernan KF, Carcillo JA. Hyperferritinemia and inflammation. Int Immunol. 2017;29:401‐409.
23. Carcillo JA, Sward K, Halstead ES, et al. A systemic inflammation mortality risk assessment contingency table for severe sepsis. Pediatr Crit Care Med. 2017;18:143‐150.
24. Huang Y, Lu Y, Huang YM, Wang M, Ling W, Sui Y, Zhao HL. Obesity in patients with COVID-19: a systematic review and meta-analysis. Metabolism. 2020 Dec;113:154378
25. Huang J.F., Wang X.B., Zheng K.I., Liu W.Y., Chen J.J., George J. Letter to the editor: obesity hypoventilation syndrome and severe COVID-19. Metabolism. 2020;108:154249.
26. Shi L., Wang Y., Wang Y., Duan G., Yang H. Dyspnea rather than fever is a risk factor for predicting mortality in patients with COVID-19 [published online ahead of print, 2020 May 15] J Infect. 2020;S0163-4453(20):30288.
Published
2024/11/02
Section
Original paper