Post-COVID-19 illness and associations with sex and gender

Author:

Mangion Kenneth,Morrow Andrew J.,Sykes Robert,Kamdar Anna,Bagot Catherine,Bruce George,Connelly Paul,Delles Christian,Gibson Vivienne B.,Gillespie Lynsey,Barrientos Pauline Hall,Lennie Vera,Roditi Giles,Sattar Naveed,Stobo David,Allwood-Spiers Sarah,McConnachie Alex,Berry Colin,Blyth Kevin G.,Briscoe Michael,Church Colin,Dobbin Stephen,Gillis Keith,Ho Antonia,Lowe David J.,Mayne Kaitlin J.,Mark Patrick B.,McGinley Christopher,McKee Connor,Peck Oliver,Rankin Alastair J.,Rooney Claire,Spiers Sarah A.,Stobo David,Wereski Ryan,Wright Sylvia,Abel Lynn,Grieve Douglas,Bayes Hannah,Carberry Jaclyn,Doherty Daniel,Ferguson Ian,Goldie Fraser,Knox Laura,Scot Katherine,Stobo David,Sharma Varun,Brown Ammani,Dougherty Andrew,Fallon Kirsty,Gilmour Lesley,Cowan Chloe,Kean Sharon,Van-Melckebeke Jurgen,Moran-Jones Kim,Stuart Debra,Travers Maureen,Hopkins Tracey,Dymock Laura,McLennan Evonne,Woodward Rosemary,Savage Fiona,Tynan Nicola,Chang Sau Lee,Dupre Mhairi,Norton Lindsey,Peng Liam,Orange Clare,Gunson Rory,Gonzalez-Lopez Rosario,Stace Rebecca,Butler Elaine,Lees Jennifer S.,Touyz Rhian M.,Welsh Paul,Palmarini Massimo,Cleland John G. F.,Kean Sharon,Kelly Bernard,McIntosh Alasdair,Russell Dionne,Weeden Sarah,Macfarlane Peter W.,Inglis Louise,Watt Jean,McLaren Kathryn,Latif Shahid,Hill Nick,Husmeier Dirk,Luo Xiaoyu,Kellman Peter,Xue Hui,Collinsworth Amy,Mullen Sarah,Rogers Campbell,Bulluck Heerajnarain,Carrick David,Corcoran David,Findlay Iain,Lang Ninian N.,McGeoch Ross,Nordin Sabrina,Payne Alexander,Robertson Keith,Ryan Nicola,Veldtman Gruschen,Weir Robin P.,Watkins Stuart,Basu Neil,McInnes Iain,Siebert Stefan,

Abstract

Abstract Background Post-COVID-19 syndromes have associated with female sex, but the pathophysiological basis is uncertain. Aim There are sex differences in myocardial inflammation identified using cardiac magnetic resonance (CMR) in post-COVID-19 patients, and in patient reported health outcomes following COVID-19 infection. Design This prospective study investigated the time-course of multiorgan injury in survivors of COVID-19 during convalescence. Methods Clinical information, blood biomarkers, and patient reported outcome measures were prospectively acquired at enrolment (visit 1) and 28–60 days post-discharge (visit 2). Chest computed tomography (CT) and CMR were performed at visit 2. Follow-up was carried out for serious adverse events, including death and rehospitalization. Results Sixty-nine (43%) of 159 patients recruited were female. During the index admission, females had a lower peak C-reactive protein (74 mg/l (21,163) versus 123 mg/l (70, 192) p = 0.008) and peak ferritin (229 μg/l (103, 551) versus 514 μg/l (228, 1122) p < 0.001). Using the Modified Lake-Louise criteria, females were more likely to have definite evidence of myocardial inflammation (54% (37/68) versus 33% (30/90) p = 0.003). At enrolment and 28–60 days post-discharge, enhanced illness perception, higher levels of anxiety and depression and lower predicted maximal oxygen utilization occurred more commonly in women. The mean (SD, range) duration of follow-up after hospital discharge was 450 (88) days (range 290, 627 days). Compared to men, women had lower rates of cardiovascular hospitalization (0% versus 8% (7/90); p = 0.018). Conclusions Women demonstrated worse patient reported outcome measures at index admission and 28–60 days follow-up though cardiovascular hospitalization was lower.

Funder

Chief Scientist Office

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine

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