Viruses (Mar 2022)

Sex-Dependent Differences in Predictive Value of the C<sub>2</sub>HEST Score in Subjects with COVID-19—A Secondary Analysis of the COLOS Study

  • Piotr Rola,
  • Adrian Doroszko,
  • Małgorzata Trocha,
  • Katarzyna Giniewicz,
  • Krzysztof Kujawa,
  • Marek Skarupski,
  • Damian Gajecki,
  • Jakub Gawryś,
  • Tomasz Matys,
  • Ewa Szahidewicz-Krupska,
  • Barbara Adamik,
  • Krzysztof Kaliszewski,
  • Katarzyna Kiliś-Pstrusińska,
  • Agnieszka Matera-Witkiewicz,
  • Michał Pomorski,
  • Marcin Protasiewicz,
  • Marcin Madziarski,
  • Urszula Chrostek,
  • Joanna Radzik-Zając,
  • Anna Radlińska,
  • Anna Zaleska,
  • Krzysztof Letachowicz,
  • Wojciech Pisarek,
  • Mateusz Barycki,
  • Janusz Sokołowski,
  • Ewa Anita Jankowska,
  • Katarzyna Madziarska

DOI
https://doi.org/10.3390/v14030628
Journal volume & issue
Vol. 14, no. 3
p. 628

Abstract

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Background: Since the outbreak of the COVID-19 pandemic, a growing number of evidence suggests that COVID-19 presents sex-dependent differences in clinical course and outcomes. Nevertheless, there is still an unmet need to stratify the risk for poor outcome at the beginning of hospitalization. Since individual C2HEST components are similar COVID-19 mortality risk factors, we evaluated sex-related predictive value of the score. Material and Methods: A total of 2183 medical records of consecutive patients hospitalized due to confirmed SARS-CoV-2 infections were analyzed. Subjects were assigned to one of two of the study arms (male vs. female) and afterward allocated to different stratum based on the C2HEST score result. The measured outcomes included: in-hospital-mortality, three-month- and six-month-all-cause-mortality and in-hospital non-fatal adverse clinical events. Results: The C2HEST score predicted the mortality with better sensitivity in female population regarding the short- and mid-term. Among secondary outcomes, C2HEST-score revealed predictive value in both genders for pneumonia, myocardial injury, myocardial infarction, acute heart failure, cardiogenic shock, and acute kidney injury. Additionally in the male cohort, the C2HEST value predicted acute liver dysfunction and all-cause bleeding, whereas in the female arm-stroke/TIA and SIRS. Conclusion: In the present study, we demonstrated the better C2HEST-score predictive value for mortality in women and illustrated sex-dependent differences predicting non-fatal secondary outcomes.

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