CO-St (COVID 19-study): sex differences in the treatment of COVID-19

Since December 2019, with the spreading of the pandemic, a lot of medical centers registered data about their patients. In Italy, the most relevant quantity of patients was hospitalized in internal medicine wards. In this observational, retrospective cross-sectional study, all data of the COVID-19 patients admitted to some Lazio hospitals from March 01 to December 31, 2020, were collected, and their epidemiological data, demographics, signs and symptoms on admission, comorbidities, laboratory findings, chest radiography and computed tomography findings, treatment received, and mortality rate were analyzed to find any differences between sexes in terms of disease gravity. Clinician details were registered on a database (one for each hospital). Cost analysis was performed taking into account the length of stay and the employed antiviral drugs, using the point of view of the Italian Healthcare System. A total of 2256 patients with a mean age of 71.01±28.02 years were included. For men, the frequency of hypertension, chronic obstructive pulmonary disease (COPD), use of oxygen therapy, and tocilizumab was significantly higher, and the epidemiological link was related to the rehabilitation ward and community. The length of stay was found to be longer for men than women. No strong difference by sex was observed in terms of death rate. Considering antiviral drugs and hospitalization duration, on average a man costs €591.2 more than a woman. In conclusion, in male patients, hypertension and COPD were observed more frequently, and the epidemiological link was related to the rehabilitation ward and the community. In female patients, the epidemiological link was related to the hospital, and we observed significantly higher atypical chest X-rays. Tocilizumab, oxygen therapy, and antiviral drugs were prescribed more in male subjects. We did not find differences based on sex in other treatments and outcomes. Future studies should be carried out to get a more comprehensive understanding of sex differences in COVID-19 treatment.