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      Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission

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          Abstract

          Anecdotal evidence suggests that Coronavirus disease 2019 (COVID-19), caused by the coronavirus SARS-CoV-2, exhibits differences in morbidity and mortality between sexes. Here, we present a meta-analysis of 3,111,714 reported global cases to demonstrate that, whilst there is no difference in the proportion of males and females with confirmed COVID-19, male patients have almost three times the odds of requiring intensive treatment unit (ITU) admission (OR = 2.84; 95% CI = 2.06, 3.92) and higher odds of death (OR = 1.39; 95% CI = 1.31, 1.47) compared to females. With few exceptions, the sex bias observed in COVID-19 is a worldwide phenomenon. An appreciation of how sex is influencing COVID-19 outcomes will have important implications for clinical management and mitigation strategies for this disease.

          Abstract

          Anecdotal reports suggest potential severity and outcome differences between sexes following infection by SARS-CoV-2. Here, the authors perform meta-analyses of more than 3 million cases collected from global public data to demonstrate that male patients with COVID-19 are 3 times more likely to require intensive care, and have ~40% higher death rate.

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          Most cited references67

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          Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

          In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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            Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study

            Summary Background An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus 2 (SARS-CoV-2) started in December, 2019, in Wuhan, China. Information about critically ill patients with SARS-CoV-2 infection is scarce. We aimed to describe the clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia. Methods In this single-centered, retrospective, observational study, we enrolled 52 critically ill adult patients with SARS-CoV-2 pneumonia who were admitted to the intensive care unit (ICU) of Wuhan Jin Yin-tan hospital (Wuhan, China) between late December, 2019, and Jan 26, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were all collected. Data were compared between survivors and non-survivors. The primary outcome was 28-day mortality, as of Feb 9, 2020. Secondary outcomes included incidence of SARS-CoV-2-related acute respiratory distress syndrome (ARDS) and the proportion of patients requiring mechanical ventilation. Findings Of 710 patients with SARS-CoV-2 pneumonia, 52 critically ill adult patients were included. The mean age of the 52 patients was 59·7 (SD 13·3) years, 35 (67%) were men, 21 (40%) had chronic illness, 51 (98%) had fever. 32 (61·5%) patients had died at 28 days, and the median duration from admission to the intensive care unit (ICU) to death was 7 (IQR 3–11) days for non-survivors. Compared with survivors, non-survivors were older (64·6 years [11·2] vs 51·9 years [12·9]), more likely to develop ARDS (26 [81%] patients vs 9 [45%] patients), and more likely to receive mechanical ventilation (30 [94%] patients vs 7 [35%] patients), either invasively or non-invasively. Most patients had organ function damage, including 35 (67%) with ARDS, 15 (29%) with acute kidney injury, 12 (23%) with cardiac injury, 15 (29%) with liver dysfunction, and one (2%) with pneumothorax. 37 (71%) patients required mechanical ventilation. Hospital-acquired infection occurred in seven (13·5%) patients. Interpretation The mortality of critically ill patients with SARS-CoV-2 pneumonia is considerable. The survival time of the non-survivors is likely to be within 1–2 weeks after ICU admission. Older patients (>65 years) with comorbidities and ARDS are at increased risk of death. The severity of SARS-CoV-2 pneumonia poses great strain on critical care resources in hospitals, especially if they are not adequately staffed or resourced. Funding None.
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              Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

              There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).
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                Author and article information

                Contributors
                kate.webb@uct.ac.za
                c.deakin@ucl.ac.uk
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                9 December 2020
                9 December 2020
                2020
                : 11
                : 6317
                Affiliations
                [1 ]Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, UK
                [2 ]GRID grid.83440.3b, ISNI 0000000121901201, Centre for Rheumatology Research, Division of Medicine, UCL, ; London, UK
                [3 ]GRID grid.83440.3b, ISNI 0000000121901201, Infection, Immunity and Inflammation Research and Teaching Department, , UCL Great Ormond Street Institute of Child Health, ; London, UK
                [4 ]GRID grid.451056.3, ISNI 0000 0001 2116 3923, NIHR Biomedical Research Centre at Great Ormond Street Hospital, ; London, UK
                [5 ]GRID grid.7836.a, ISNI 0000 0004 1937 1151, Department of Paediatric Rheumatology, School of Child and Adolescent Health, Red Cross War Memorial Children’s Hospital, , University of Cape Town, ; Cape Town, South Africa
                [6 ]GRID grid.451388.3, ISNI 0000 0004 1795 1830, The Francis Crick Institute, , Crick African Network, ; London, UK
                Author information
                http://orcid.org/0000-0002-9668-4683
                http://orcid.org/0000-0002-2694-0426
                http://orcid.org/0000-0002-3462-0502
                http://orcid.org/0000-0002-3885-3477
                http://orcid.org/0000-0002-8911-4113
                http://orcid.org/0000-0002-7495-1429
                http://orcid.org/0000-0003-4800-4695
                http://orcid.org/0000-0003-1087-5946
                http://orcid.org/0000-0002-7044-5801
                Article
                19741
                10.1038/s41467-020-19741-6
                7726563
                33298944
                0054f334-8cee-42ac-8b85-af41fa6715ed
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 16 April 2020
                : 23 October 2020
                Funding
                Funded by: Versus Arthritis Studentship 22203
                Funded by: Medical Research Foundation Lupus Fellowship MRF-057-0001-RG-ROSS-C0797
                Funded by: NIHR Biomedical Research Centre at University College London Hospital (BRC/III 525)
                Funded by: Centre of Excellence (Centre for Adolescent Rheumatology Versus Arthritis) grant (21593) Medical Research Council (MR/R013926/1) Great Ormond Street Children’s Charity NIHR Biomedical Research Centre at Great Ormond Street Hospital
                Funded by: Medical Research Foundation Lupus Fellowship (MRF-057-0001-RG-ROSS-C0797)
                Funded by: The Francis Crick Institute, Crick African Network
                Categories
                Article
                Custom metadata
                © The Author(s) 2020

                Uncategorized
                systems analysis,viral infection,epidemiology,risk factors
                Uncategorized
                systems analysis, viral infection, epidemiology, risk factors

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