Sex disparities in COVID-19 outcomes of inpatients with diabetes: insights from the CORONADO study.

Autor:	Tramunt B; Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France., Smati S; Nantes University, Nantes University Hospital, CNRS, INSERM, L'Institut du Thorax, Nantes, France., Coudol S; CIC-EC 1413, Data Clinic., Wargny M; Nantes University, Nantes University Hospital, CNRS, INSERM, L'Institut du Thorax, Nantes, France.; CIC-EC 1413, Data Clinic., Pichelin M; Nantes University, Nantes University Hospital, CNRS, INSERM, L'Institut du Thorax, Nantes, France., Guyomarch B; Research Department, Methodology and Biostatistics Platform, Nantes University Hospital, Nantes, France., Al-Salameh A; Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France.; PériTox=UMR_I 01, University of Picardie Jules Verne, Amiens, France., Amadou C; Department of Diabetology, Sud Francilien Hospital Center, Corbeil Essonne, France., Barraud S; CRESTIC EA 3804, University of Reims Champagne Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la Housse, Reims, France.; Department of Endocrinology-Diabetes-Nutrition, Reims University Hospital, Avenue du Général Koenig, Reims, France., Bigot E; Department of Biochemistry, Nantes University Hospital, G et R Laënnec Hospital, Bd Jacques Monod, Nantes, France., Bordier L; Department of Endocrinology, Bégin Hospital, Saint-Mandé, France., Borot S; Department of Endocrinology, Diabetology and Nutrition, Besançon University Hospital, Besançon, France., Bourgeon M; Department of Endocrinology, Diabetology and Nutrition, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Antoine Béclère Hospital, Clamart, Bicêtre Hospital, Le Kremlin Bicêtre, France., Bourron O; Department of Diabetology, Sorbonne University, Assistance Publique Hôpitaux de Paris, La Pitié Salpêtrière-Charles Foix University Hospital, Inserm, UMR_S 1138, Cordeliers Research Center, Paris 06, Institute of Cardiometabolism and Nutrition ICAN, Paris, France., Charrière S; Federation of Endocrinology - Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, INSERM UMR 1060 Carmen, Claude Bernard Lyon 1 University, Lyon, France., Chevalier N; University of Côte d'Azur, University Hospital, Inserm U1065, C3M, Nice, France., Cosson E; Department of Endocrinology, Diabetology and Nutrition, Assistance Publique Hôpitaux de Paris, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France.; Paris 13 University, Sorbonne Paris Cité, UMR U557 Inserm/U11125 INRAE/CNAM/Paris13 University, Nutritional Epidemiological Research Unit, Bobigny, France., Fève B; Department of Endocrinology, Assistance Publique Hôpitaux de Paris, Saint-Antoine Hospital, Reference Center of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Paris, France.; Sorbonne University, Inserm UMRS 938, Saint-Antoine Research Center, Paris, France., Flaus-Furmaniuk A; Department of Endocrinology-Diabetology, Felix Guyon Site, University Hospital of la Réunion, Saint-Denis de la Réunion, France., Fontaine P; Department of Endocrinology, Diabetology and Nutrition, Hospital of Huriez, Lille University Hospital, Lille, France., Galioot A; Department of Endocrinology, Diabetology and Nutrition, Bordeaux University Hospital and University of Bordeaux, Bordeaux, France., Gonfroy-Leymarie C; Department of Endocrinology and Diabetology, Hospital of Pontoise, Pontoise, France., Guerci B; Lorraine University and Endocrinology, Diabetology, Metabolic Diseases and Nutrition, Nancy University Hospital, Nancy, France., Lablanche S; Grenoble Alpes University, INSERM U1055, LBFA, Endocrinology, Grenoble Alpes University Hospital, France., Lalau JD; Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France.; PériTox=UMR_I 01, University of Picardie Jules Verne, Amiens, France., Larger E; Department of Diabetology, Cochin Hospital, AP-HP, Paris University, Paris, France., Lasbleiz A; Department of Endocrinology, Diabetology and Nutrition, Hospital of la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France.; Aix Marseille University, INSERM, INRA, C2VN, Marseille, France., Laviolle B; Rennes University, Rennes University Hospital, Inserm, CIC 1414 (Clinical Investigation Center), Rennes, France., Marre M; Ambroise Paré Neuilly-sur-Seine Hospital, Cordeliers Research Center, Paris Diderot University, Paris, France., Munch M; Department of Endocrinology, Diabetology and Nutrition, Strasbourg University Hospitals, Strasbourg, France., Potier L; Department of Endocrinology, Diabetology and Nutrition, Bichat Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.; Cordeliers Research Center, Inserm, U-1138, Paris University, Paris, France., Prevost G; Department of Endocrinology, Diabetes and Metabolic Diseases, Normandie University, UNIROUEN, Rouen University Hospital, Rouen, France., Renard E; Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, INSERM Clinical Investigation Centre, Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, Montpellier, France., Reznik Y; Department of Endocrinology and Diabetology, University Hospital of Côte de Nacre, Caen Cedex, France., Seret-Bégué D; Department of Diabetology, Hospital of Gonesse, Gonesse, France., Sibilia P; Department of Endocrinology, Diabetology and Nutrition, Angers University Hospital, Angers, France., Thuillier P; Department of Endocrinology, Brest University Hospital, EA 3878 GETBO, Brest, France., Vergès B; Department of Endocrinology, Diabetology and Metabolic Diseases, Hospital of Bocage, Dijon, France., Gautier JF; Department of Diabetology and Endocrinology, Lariboisière Hospital, APHP, Paris, France.; INSERM UMRS 1138, Paris Diderot-Paris VII University, Sorbonne Paris Cité, Paris, France., Hadjadj S; Nantes University, Nantes University Hospital, CNRS, INSERM, L'Institut du Thorax, Nantes, France., Cariou B; Nantes University, Nantes University Hospital, CNRS, INSERM, L'Institut du Thorax, Nantes, France., Mauvais-Jarvis F; Section of Endocrinology, John W Deming Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.; Southeast Louisiana Veterans Health Care System Medical Center, New Orleans, Louisiana, USA.; Tulane Center of Excellence in Sex-Based Biology and Medicine, New Orleans, Louisiana, USA., Gourdy P; Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France.
Jazyk:	angličtina
Zdroj:	European journal of endocrinology [Eur J Endocrinol] 2021 Jul 05; Vol. 185 (2), pp. 299-311. Date of Electronic Publication: 2021 Jul 05.
DOI:	10.1530/EJE-21-0068
Abstrakt:	Objective: Male sex is one of the determinants of severe coronavirus diseas-e-2019 (COVID-19). We aimed to characterize sex differences in severe outcomes in adults with diabetes hospitalized for COVID-19. Methods: We performed a sex-stratified analysis of clinical and biological features and outcomes (i.e. invasive mechanical ventilation (IMV), death, intensive care unit (ICU) admission and home discharge at day 7 (D7) or day 28 (D28)) in 2380 patients with diabetes hospitalized for COVID-19 and included in the nationwide CORONADO observational study (NCT04324736). Results: The study population was predominantly male (63.5%). After multiple adjustments, female sex was negatively associated with the primary outcome (IMV and/or death, OR: 0.66 (0.49-0.88)), death (OR: 0.49 (0.30-0.79)) and ICU admission (OR: 0.57 (0.43-0.77)) at D7 but only with ICU admission (OR: 0.58 (0.43-0.77)) at D28. Older age and a history of microvascular complications were predictors of death at D28 in both sexes, while chronic obstructive pulmonary disease (COPD) was predictive of death in women only. At admission, C-reactive protein (CRP), aspartate amino transferase (AST) and estimated glomerular filtration rate (eGFR), according to the CKD-EPI formula predicted death in both sexes. Lymphocytopenia was an independent predictor of death in women only, while thrombocytopenia and elevated plasma glucose concentration were predictors of death in men only. Conclusions: In patients with diabetes admitted for COVID-19, female sex was associated with lower incidence of early severe outcomes, but did not influence the overall in-hospital mortality, suggesting that diabetes mitigates the female protection from COVID-19 severity. Sex-associated biological determinants may be useful to optimize COVID-19 prevention and management in women and men.
Databáze:	MEDLINE
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