Sex-Dependent Differences in Predictive Value of the CHEST Score in Subjects with COVID-19-A Secondary Analysis of the COLOS Study

Since the outbreak of the COVID-19 pandemic, a growing number of evidence suggests that COVID-19 presents sex-dependent differences in clinical course and outcomes. Nevertheless, there is still an unmet need to stratify the risk for poor outcome at the beginning of hospitalization. Since individual CHEST components are similar COVID-19 mortality risk factors, we evaluated sex-related predictive value of the score. A total of 2183 medical records of consecutive patients hospitalized due to confirmed SARS-CoV-2 infections were analyzed. Subjects were assigned to one of two of the study arms (male vs. female) and afterward allocated to different stratum based on the CHEST score result. The measured outcomes included: -mortality, and all-cause-mortality and non-fatal adverse clinical events. The CHEST score predicted the mortality with better sensitivity in female population regarding the short- and mid-term. Among secondary outcomes, CHEST-score revealed predictive value in both genders for pneumonia, myocardial injury, myocardial infarction, acute heart failure, cardiogenic shock, and acute kidney injury. Additionally in the male cohort, the CHEST value predicted acute liver dysfunction and all-cause bleeding, whereas in the female arm-stroke/TIA and SIRS. In the present study, we demonstrated the better CHEST-score predictive value for mortality in women and illustrated sex-dependent differences predicting non-fatal secondary outcomes.