Marked Global Differences in Mortality in Male Patients with COVID-19: An Analysis of the CARDIO COVID 19-20 and WHF COVID-19 CVD Studies.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI:10.5334/gh.1403

Juan Esteban Gómez-Mesa, Juan Pablo Arango-Ibanez, Pablo Perel, Dorairaj Prabhakaran, Hoover O León-Giraldo, Alejandro Toro-Pedroza, Ricardo Enrique Larrea Gómez, César J Herrera, Julián Lugo-Peña, Liliana Patricia Cárdenas Alaz, Victor Rossel, Daniel Sierra-Lara, Jessica Mercedes, Clara Inés Saldarriaga-Giraldo, María Juliana Rodríguez-González, Armando Alvarado, Juan Carlos Ortega, Miguel Quintana Da Silva, Kavita Singh, Karen Sliwa

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引用次数: 0

Abstract

Background: COVID-19 has led to nearly seven million deaths and male sex has been reported as one of the main risk factors for mortality. Few studies have analyzed cohorts of male patients, especially in underrepresented regions in the medical literature, such as low and middle-income nations. To address this gap, we conducted large-scale, male-specific, multinational analyses, to improve understanding of factors associated with mortality in this high-risk population and global variations.

Methods: This is a prospective, multicenter study that includes data from the CARDIO COVID-19-20 registry and the WHF COVID-19 CVD study. A multiple Poisson regression model was performed to evaluate differences in factors associated with in-hospital mortality among male COVID-19 patients across different regions.

Results: We analyzed 4,899 hospitalized male COVID-19 patients from 32 countries: Africa (11.2%), the Americas (44.7%), Asia (33.8%), and Europe (10.2%). Median age was 59 years (IQR: 47-69), with 50.5% aged 40-64. ICU admission was 42.4%, and mortality was 19.2%, with marked regional differences (ranging from 6% in Europe to 26.9% in the Americas). Poisson regression showed age >80 years (aRR = 4.21) and IMV (aRR = 3.80) as the strongest factors associated with mortality. Other factors included diabetes, chronic kidney disease, myocarditis, and decompensated heart failure. Mortality risk was higher in Africa (aRR = 3.86), Asia (aRR = 2.72), and the Americas (aRR = 2.23) compared to Europe (p < 0.001). Anticoagulation/Antiplatelet therapy showed a potential correlation with survival.

Conclusion: This study reflects the complexity of factors influencing COVID-19 mortality among male patients hospitalized with COVID-19, emphasizing global variability. The substantial differences in mortality noted across countries are likely due to differences in disease severity, comorbidities, clinical care, and health system factors. Age remains a primary risk factor, with older populations particularly vulnerable. Our findings underscore the need for targeted and tailored regional approaches to manage male COVID-19 patients.

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COVID-19 男性患者死亡率的显著全球差异：CARDIO COVID 19-20 和 WHF COVID-19 心血管疾病研究分析。

背景：COVID-19已导致近700万人死亡，据报道，男性已成为死亡的主要风险因素之一。很少有研究分析男性患者群体，特别是在医学文献中代表性不足的地区，如低收入和中等收入国家。为了解决这一差距，我们进行了大规模的、针对男性的、跨国的分析，以提高对高危人群死亡率相关因素和全球变化的理解。方法：这是一项前瞻性多中心研究，包括来自CARDIO COVID-19-20注册中心和WHF COVID-19- CVD研究的数据。采用多元泊松回归模型评估不同地区男性COVID-19患者住院死亡率相关因素的差异。结果：我们分析了来自32个国家的4899名住院男性COVID-19患者：非洲（11.2%）、美洲（44.7%）、亚洲（33.8%）和欧洲（10.2%）。中位年龄59岁（IQR: 47-69）， 40-64岁占50.5%。ICU住院率为42.4%，死亡率为19.2%，地区差异显著（欧洲为6%，美洲为26.9%）。泊松回归显示，年龄（aRR = 4.21）和IMV （aRR = 3.80）是与死亡率相关的最强因素。其他因素包括糖尿病、慢性肾病、心肌炎和失代偿性心力衰竭。与欧洲相比，非洲（aRR = 3.86）、亚洲（aRR = 2.72）和美洲（aRR = 2.23）的死亡率风险更高（p < 0.001）。抗凝/抗血小板治疗显示出与生存率的潜在相关性。结论：本研究反映了男性住院患者COVID-19死亡率影响因素的复杂性，强调了全球变异性。各国之间死亡率的巨大差异可能是由于疾病严重程度、合并症、临床护理和卫生系统因素的差异。年龄仍然是一个主要的危险因素，老年人尤其容易受到伤害。我们的研究结果强调，需要采取有针对性和量身定制的区域方法来管理男性COVID-19患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.