Long-term outcome after intensive care for COVID-19: differences between men and women-a nationwide cohort studyShow others and affiliations
2021 (English)In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 25, no 1, article id 86
Article in journal (Refereed) Published
Abstract [en]
BackgroundQuestions remain about long-term outcome for COVID-19 patients in general, and differences between men and women in particular given the fact that men seem to suffer a more dramatic course of the disease. We therefore analysed outcome beyond 90 days in ICU patients with COVID-19, with special focus on differences between men and women.MethodsWe identified all patient >= 18 years with COVID-19 admitted between March 6 and June 30, 2020, in the Swedish Intensive Care Registry. Patients were followed until death or study end-point October 22, 2020. Association with patient sex and mortality, in addition to clinical variables, was estimated using Cox regression. We also performed a logistic regression model estimating factors associated with 90-day mortality.ResultsIn total, 2354 patients with COVID-19 were included. Four patients were still in the ICU at study end-point. Median follow-up time was 183 days. Mortality at 90-days was 26.9%, 23.4% in women and 28.2% in men. After 90 days until end of follow-up, only 11 deaths occurred. On multivariable Cox regression analysis, male sex (HR 1.28, 95% CI 1.06-1.54) remained significantly associated with mortality even after adjustments. Additionally, age, COPD/asthma, immune deficiency, malignancy, SAPS3 and admission month were associated with mortality. The logistic regression model of 90-day mortality showed almost identical results. ConclusionsIn this nationwide study of ICU patients with COVID-19, men were at higher risk of poor long-term outcome compared to their female counterparts. The underlying mechanisms for these differences are not fully understood and warrant further studies.
Place, publisher, year, edition, pages
BMC , 2021. Vol. 25, no 1, article id 86
Keywords [en]
COVID-19; Intensive care; Long-term outcome; Gender
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:liu:diva-174782DOI: 10.1186/s13054-021-03511-xISI: 000624580500005PubMedID: 33632273Scopus ID: 2-s2.0-85101707916OAI: oai:DiVA.org:liu-174782DiVA, id: diva2:1541703
Note
Funding Agencies|Karolinska InstituteKarolinska Institutet; Knut and Alice Wallenberg FoundationKnut & Alice Wallenberg Foundation [2020.0182]; Swedish Society of Medicine
2021-04-012021-04-012025-10-31