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

Since December 2019, with the spreading of the pan- demic, a lot of medical centers registered data about their pa- tients. 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, co- morbidities, laboratory findings, chest radiography and com- puted 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 per- formed taking into account the length of stay and the em- ployed 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 signif- icantly 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 an- tiviral drugs and hospitalization duration, on average a man costs €591.2 more than a woman. In conclusion, in male pa- tients, hypertension and COPD were observed more fre- quently, 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 ob- served significantly higher atypical chest X-rays. Tocilizumab, oxygen therapy, and antiviral drugs were pre- scribed 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 under- standing of sex differences in COVID-19 treatment.