https://doi.org/10.4081/itjm.2025.1916

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

Vol. 19 No. 1 (2025)
Published: 10 March 2025
COVID-19, SARS-CoV-2, cost-effectiveness, health policy, gender differences
Abstract Views: 243
PDF: 76
HTML: 1
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Manuel Monti
montimanuel@tiscali.it
https://orcid.org/0000-0003-0478-110X
Emergency Department, Gubbio-Gualdo Tadino Hospital, Local Health Authority Umbria 1, Gubbio, Italy.
Tiziana Ciarambino
Internal Medicine Department, Hospital of Marcianise, Caserta, Italy.
Filomena Pietrantonio
Internal Medicine Department, Castelli Hospital, Local Health Authority Roma 6, Ariccia, Italy.
Sara Rotunno
Internal Medicine Department, Hospital of S. Pietro Fatebenefratelli, Rome, Italy.
Alessandra Fiorentini
Internal Medicine Department, Belcolle Hospital, Viterbo, Italy.
Rosalba Cipriani
Internal Medicine Department, F. Spaziani Hospital, Frosinone, Italy.
Giuseppe Campagna
Internal Medicine Department, S. Maria Goretti Hospital, Latina, Italy.
Giuseppe Straface
Science Medical Department, Local Health Authority of Latina, Italy.
Eleonora Pistella
Internal Medicine Department, Vannini Hospital, Rome, Italy.
Mauro Giordano
Internal Medicine Department, University of Campania, Caserta, Italy.
Orazio Valerio Giannico
Department of Prevention, Local Health Authority of Taranto, Italy.
Roberto Marchetti
Department of Clinical Psychology, Villa Maraini Foundation, Rome, Italy.
Federica Lorenzi
Internal Medicine Department, L. Parodi Delfino Hospital, Colleferro, Italy.
Francesco Rosiello
https://orcid.org/0000-0002-6532-1185
Internal Medicine Department, Castelli Hospital, Local Health Authority Roma 6, Ariccia; Department of Public Health and Infectious Disease, Sapienza University of Rome, Italy.

Since December 2019, with the spreading of the pandemic, a lot of medical centers registered data about their patients. 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, comorbidities, laboratory findings, chest radiography and computed 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 performed taking into account the length of stay and the employed 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 significantly 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 antiviral drugs and hospitalization duration, on average a man costs €591.2 more than a woman. In conclusion, in male patients, hypertension and COPD were observed more frequently, 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 observed significantly higher atypical chest X-rays. Tocilizumab, oxygen therapy, and antiviral drugs were prescribed 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 understanding of sex differences in COVID-19 treatment.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Perlman S. Another decade, another coronavirus. N Engl J Med 2020;382:760-2. DOI: https://doi.org/10.1056/NEJMe2001126
World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 February 2020. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. Accessed: 18/06/2024.
Monti M, L’Angiocola PD, Marchetti R, et al. Strategies for prevention of SARS-CoV-2 infection in a rural Emergency Department. Hong Kong J Emerg Med 2021;28:114-6. DOI: https://doi.org/10.1177/1024907920965851
Grasselli G, Zangrillo A, Zanella A, et al. COVID-19. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA 2020;323:1574-81. DOI: https://doi.org/10.1001/jama.2020.5394
Ilardi AA, Politi C, Ciarambino T. COVID-19: could sex and age be a risk factor? Minerva Med 2023;114:391-2. DOI: https://doi.org/10.23736/S0026-4806.20.06705-1
Tejpal A, Gianos E, Cerise J, et al. Sex-based differences in COVID-19 outcomes. J Womens Health 2021;30:492-501. DOI: https://doi.org/10.1089/jwh.2020.8974
Fink AL, Klein SL. Sex and gender impact immune responses to vaccines among the elderly. Physiology 2015;30:408-16. DOI: https://doi.org/10.1152/physiol.00035.2015
Parikh P, Wicher S, Khandalavala K, et al. Cellular senescence in the lung across the age spectrum. Am J Physiol Lung Cell Mol Physiol 2019;316:L826-42. DOI: https://doi.org/10.1152/ajplung.00424.2018
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5
Hazeldine J, Lord JM. Immunesenescence: a predisposing risk factor for the development of COVID-19? Front Immunol 2020;11:573662. DOI: https://doi.org/10.3389/fimmu.2020.573662
Borghesi A, Zigliani A, Maroldi R, et al. Radiographic severity index in Covid-19 pneumonia: relationship to age and sex in 783 Italian patients. Radiol Med 2020;125:461-4. DOI: https://doi.org/10.1007/s11547-020-01202-1
Foglia E, Ferrario L, Schettini F, et al. COVID-19 and hospital management costs: the Italian experience. BMC Health Serv Res 2022;22:991. DOI: https://doi.org/10.1186/s12913-022-08365-9
Pietrantonio F, Rosiello F, Alessi E, et al. Burden of COVID-19 on Italian Internal Medicine Wards: delphi, SWOT, and performance analysis after two pandemic waves in the local health authority “Roma 6” hospital structures. Int J Environ Res Public Health 2021;18:5999. DOI: https://doi.org/10.3390/ijerph18115999
Martínez de Toda I, González-Sánchez M, Díaz-Del Cerro E, et al. Sex differences in markers of oxidation and inflammation. Implications for ageing. Mech Ageing Dev 2023;211:111797. DOI: https://doi.org/10.1016/j.mad.2023.111797
Molony RD, Malawista A, Montgomery RR. Reduced dynamic range of antiviral innate immune responses in aging. Exp Gerontol 2018;107:130-5. DOI: https://doi.org/10.1016/j.exger.2017.08.019
Baker RE, Mahmud AS, Miller IF, et al. Infectious disease in an era of global change. Nat Rev Microbiol 2022;20:193-205. DOI: https://doi.org/10.1038/s41579-021-00639-z
Paciullo F, Giannandrea D, Gianfredi V, et al. Epidemiology of emergency calls for time-dependent acute illnesses during COVID-19 outbreak in Umbria region (Italy). Ann Ig 2021;33:198-200.
Monti M, Carnevali G, Marchetti R. Prospettive future nel campo della pandemia e del rischio biologico. Ital J Prev Diagn Ther Med 2024;7:17-20.

How to Cite

Monti, M., Ciarambino, T., Pietrantonio, F., Rotunno, S., Fiorentini, A., Cipriani, R., Campagna, G., Straface, G., Pistella, E., Giordano, M., Giannico, O. V., Marchetti, R., Lorenzi, F., & Rosiello, F. (2025). CO-St (COVID 19-study): sex differences in the treatment of COVID-19. Italian Journal of Medicine, 19(1). https://doi.org/10.4081/itjm.2025.1916
Copyright (c) 2025 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.