Sex-specific Treatment Characteristics and 30-day Mortality Outcomes of Critically Ill COVID-19 Patients over 70 Years of Age-results from the Prospective COVIP Study

Overview

Journal Can J Anaesth

Specialty Anesthesiology

Date 2022 Aug 9

PMID 35945477

Authors

Georg Wolff

Bernhard Wernly

Hans Flaatten

Jesper Fjolner

Raphael Romano Bruno

Antonio Artigas

Bernardo Bollen Pinto

Joerg C Schefold

Malte Kelm

Stephan Binneboessel

Philipp Baldia

Michael Beil

Sigal Sivri

Peter Vernon van Heerden

Wojciech Szczeklik

Muhammed Elhadi

Michael Joannidis

Sandra Oeyen

Maria Flamm

Tilemachos Zafeiridis

Brian Marsh

Finn H Andersen

Rui Moreno

Ariane Boumendil

Dylan W de Lange

Bertrand Guidet

Susannah Leaver

Christian Jung

Affiliations

Soon will be listed here.

Abstract

Purpose: Older critically ill patients with COVID-19 have been the most vulnerable during the ongoing pandemic, with men being more prone to hospitalization and severe disease than women. We aimed to explore sex-specific differences in treatment and outcome after intensive care unit (ICU) admission in this cohort.

Methods: We performed a sex-specific analysis in critically ill patients ≥ 70 yr of age with COVID-19 who were included in the international prospective multicenter COVIP study. All patients were analyzed for ICU admission and treatment characteristics. We performed a multilevel adjusted regression analysis to elucidate associations of sex with 30-day mortality.

Results: A total of 3,159 patients (69.8% male, 30.2% female; median age, 75 yr) were included. Male patients were significantly fitter than female patients as determined by the Clinical Frailty Scale (fit, 67% vs 54%; vulnerable, 14% vs 19%; frail, 19% vs 27%; P < 0.001). Male patients more often underwent tracheostomy (20% vs 14%; odds ratio [OR], 1.57; P < 0.001), vasopressor therapy (69% vs 62%; OR, 1.25; P = 0.02), and renal replacement therapy (17% vs 11%; OR, 1.96; P < 0.001). There was no difference in mechanical ventilation, life-sustaining treatment limitations, and crude 30-day mortality (50% male vs 49% female; OR, 1.11; P = 0.19), which remained true after adjustment for disease severity, frailty, age and treatment limitations (OR, 1.17; 95% confidence interval, 0.94 to 1.45; P = 0.16).

Conclusion: In this analysis of sex-specific treatment characteristics and 30-day mortality outcomes of critically ill patients with COVID-19 ≥ 70 yr of age, we found more tracheostomy and renal replacement therapy in male vs female patients, but no significant association of patient sex with 30-day mortality.

Study Registration: www.

Clinicaltrials: gov (NCT04321265); registered 25 March 2020).

Citing Articles

In reply: Sex-specific outcomes in COVID-19: missing pieces of the puzzle.

Wolff G, Wernly B, Flaatten H, Fjolner J, Bruno R, Artigas A Can J Anaesth. 2023; 70(6):1110-1112.

PMID: 37165131 PMC: 10171910. DOI: 10.1007/s12630-023-02470-x.

Sex-specific outcomes in COVID-19: missing pieces of the puzzle.

Magoon R, Choudhary N Can J Anaesth. 2023; 70(6):1108-1109.

PMID: 37165130 PMC: 10171905. DOI: 10.1007/s12630-023-02469-4.

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