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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background: Increased mortality and occurrence of cardiovascular (CV) outcomes during hospitalization and in short-term follow-up for moderate to severe SARS-CoV-2 infection have been associated with male sex, yet data regarding long-term outcomes by sex and COVID-19 variant (Alpha, Delta, and Omicron) are limited. Methods: This prospective study of 4882 patients examines potential differences by sex in the occurrence of primary combined cardiovascular outcomes (CV death, CV hospitalization, myocardial infarction (MI), stroke, pulmonary embolism) as well as secondary outcomes (CV death, cardiovascular hospitalizations, myocardial infarction, stroke, pulmonary embolism) at 18-month follow-up after urgent hospitalization for SARS-CoV-2-associated pneumonia, as well as evaluating for differences during the three COVID-19 waves. Survival rate was analyzed for the entire cohort by sex and SARS-CoV-2 variant and adjusted for age using the multiple Kaplan–Meier method. To compare survival in groups of men and women for each wave, the Gehan–Wilcoxon test was applied with significance p < 0.05. Univariate Cox proportional hazards models were used to search for potential risk factors of CV death at 18-months follow-up separately for men and women in each COVID-19 wave. Results: Men had significantly higher 18-month CV mortality compared to women in the Delta wave (6.13% men vs. 3.62% women, p = 0.017). Although men had higher percentages of all other CV endpoints (excepting pulmonary embolism) at follow-up during the Delta wave, none were significant compared with women, except for the combined CV endpoint (16.87% men vs. 12.61% women, p = 0.017). No significant differences by sex in CV outcomes were seen during the Alpha and Omicron variants. Discrepancies in CV outcomes in demographical data and concomitant disease between the COVID-19 variants of concern existed. Conclusions: Higher male mortality and higher but non-significant incidences of CV outcomes occurred during the Delta wave of the COVID-19 pandemic, with the lowest incidence of CV outcomes observed during the Omicron variant.

Details

Title
Sex Differences in Long-Term Cardiovascular Outcomes and Mortality After COVID-19 Hospitalization During Alpha, Delta and Omicron Waves
Author
Kopp, Kristen 1   VIAFID ORCID Logo  ; Motloch, Lukas J 2 ; Lichtenauer, Michael 1 ; Boxhammer, Elke 1   VIAFID ORCID Logo  ; Hoppe, Uta C 1 ; Berezin, Alexander E 1   VIAFID ORCID Logo  ; Gareeva, Diana 3 ; Lakman, Irina 4   VIAFID ORCID Logo  ; Agapitov, Alexander 4   VIAFID ORCID Logo  ; Sadikova, Liana 4   VIAFID ORCID Logo  ; Timiryanova, Venera 4   VIAFID ORCID Logo  ; Davtyan, Paruir 3 ; Badykova, Elena 3   VIAFID ORCID Logo  ; Naufal Zagidullin 3   VIAFID ORCID Logo 

 University Clinic for Internal Medicine II, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria[email protected] (M.L.); [email protected] (E.B.); [email protected] (U.C.H.); [email protected] (A.E.B.) 
 University Clinic for Internal Medicine II, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria[email protected] (M.L.); [email protected] (E.B.); [email protected] (U.C.H.); [email protected] (A.E.B.); Department of Internal Medicine II, Salzkammergut Klinikum, OÖG, 4840 Vöcklabruck, Austria; Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, 4040 Linz, Austria 
 Department of Internal Diseases, Bashkir State Medical University, Lenin Str., 3, 450008 Ufa, Russia; [email protected] (D.G.); [email protected] (P.D.); [email protected] (E.B.); [email protected] (N.Z.) 
 Scientific Laboratory for the Socio-Economic Region Problems Investigation, Ufa University of Science and Technology, Zaki Validi Str. 32, 450076 Ufa, Russia; [email protected] (I.L.); 
First page
6636
Publication year
2024
Publication date
2024
Publisher
MDPI AG
e-ISSN
20770383
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3133071023
Copyright
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.