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

Blandine Tramunt 1 Sarra Smati 2 Sandrine Coudol 3, 4 Matthieu Wargny 3, 4 Matthieu Pichelin 4 Béatrice Guyomarch 4 Abdallah Al-Salameh 5, 6 Coralie Amadou 7 Sara Barraud 8, 9 Édith Bigot 4 Lyse Bordier 10 Sophie Borot Muriel Bourgeon Olivier Bourron Sybil Charriere 11 Nicolas Chevalier 12 Emmanuel Cosson 13 Bruno Fève 14 Anna Flaus-Furmaniuk 15 Pierre Fontaine 16, 17 Amandine Galioot 18 Céline Gonfroy-Leymarie Bruno Guerci 19 Sandrine Lablanche 20 Jean-Daniel Lalau 5 Etienne Larger 21 Adele Lasbleiz 22 Bruno Laviolle 23, 24 Michel Marre 25 Marion Munch 26 Louis Potier 27 Gaëtan Prévost 28 Eric Renard 29, 30 Yves Reznik 31 Dominique Seret-Begue Paul Sibilia 32 Philippe Thuillier 33 Bruno Verges 34 Jean-Francois Gautier Samy Hadjadj 3 Bertrand Cariou 2 Franck Mauvais-Jarvis 35, * Pierre Gourdy 36, *
* Auteur correspondant
Abstract : OBJECTIVE: Male sex is a determinant of severe coronavirus disease-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 2,380 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, CRP, AST and eGFR 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.
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https://hal.archives-ouvertes.fr/hal-03281915
Contributeur : Laurent Jonchère <>
Soumis le : mardi 13 juillet 2021 - 10:01:55
Dernière modification le : mercredi 22 septembre 2021 - 19:00:01

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Blandine Tramunt, Sarra Smati, Sandrine Coudol, Matthieu Wargny, Matthieu Pichelin, et al.. Sex disparities in COVID-19 outcomes of inpatients with diabetes: insights from the CORONADO study. European Journal of Endocrinology, BioScientifica, 2021, 185 (2), pp.299-311. ⟨10.1530/EJE-21-0068⟩. ⟨hal-03281915⟩

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