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The Impact of Systemic Inflammation on Sex-based Bias Following SARS-CoV-2 Infection

Received: 6 January 2022    Accepted: 22 January 2022    Published: 9 February 2022
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Abstract

Background: The unfavorable clinical outcome (higher rates of severity/morbidity/mortality) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a disproportionate bias towards the male sex despite no sex-based difference noted in the risk for the infection. These outcomes have widely been hinged on dysregulated systemic inflammation. Hence, this study was aimed to evaluate the influence of systemic inflammation on sex-based bias in SARS-CoV-2 infection among indigenes of Nigerian Methods: Patients’ data with positive real-time polymerase chain reaction (RT-PCR) test for coronavirus disease 2019 (COVID-19), who were admitted/managed at the Eleme treatment center in Port Harcourt, southern Nigeria, were enrolled for this study. All relevant data was acquired from archived case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using validated data collection templates. All the collated/abstracted data were analyzed/compared between the male and female patients using both descriptive and comparative statistical tools. Results A total of eligible 598 patients were included in the analysis among them 373 (62.4%) and 225 (37.6%) males and females, respectively. The males were much older (43.63±5.93 vs. 41.15±6.09; p<0.036) with higher mean body mass index and body temperature at presentation. Significant differences were observed in terms of the age distribution, occupational, educational, marital, residential status, cigarette smoking, alcohol consumption, body mass index, comorbid, severity, and clinical outcomes between the males and females (<0.05). In addition, the males had significantly higher mean levels of creatinine, C-reactive protein (CRP), Glasgow Prognostic Score (GPS), D-dimer, total WBC, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR) but lower levels of albumin, total protein, isolated platelet count, and isolated lymphocyte count (p<0.05). The males maintained a significant linear relationship with the CRP (β: 0.61; SE: 0.13; p<0.001), composite GPS (β: 0.59; SE: 0.01; p<0.001), D-dimer (β: 0.52; SE: 0.09; p<0.001), and the composite NLR (β: 0.38; SE: 0.10; p<0.001) compare to their female counterparts. Additionally, CRP (OR: 8.86; 95%CI: 7.34-9.78; p<0.001), the composite GPS (OR: 7.41; 95%CI: 6.36-8.79; p<0.001), D-dimer (OR: 5.4; 95%CI: 4.32-6.65), and the composite NLR (OR: 4.23; 95%CI: 3.44-5.69; p<0.001) all had significant and robust associations with unfavorable clinical outcomes among the males compared to the females. Conclusion: Exaggerated systemic inflammatory markers/indices were more pronounced among the males in association with unfavorable clinical outcomes. These sex-based characteristics should be factored in during the management of SARS-CoV-2 infection. However, further studies are recommended to evaluate conclusions from the current study.

Published in European Journal of Clinical and Biomedical Sciences (Volume 8, Issue 1)
DOI 10.11648/j.ejcbs.20220801.11
Page(s) 1-8
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

SARS-CoV-2, COVID-19, Sex-based Inflammatory Markers/Indices

References
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[6] Lau ES, McNeill JN, Paniagua SM, Liu EE, Wang JK, Bassett IV, et al. Sex differences in inflammatory markers in patients hospitalized with COVID-19 infection: Insights from the MGH COVID-19 patient registry. PLoS One. 2021; 16 (4): e0250774. DOI: 10.1371/journal.pone.0250774.
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Cite This Article
  • APA Style

    Collins Amadi, Stephenson Lawson. (2022). The Impact of Systemic Inflammation on Sex-based Bias Following SARS-CoV-2 Infection. European Journal of Clinical and Biomedical Sciences, 8(1), 1-8. https://doi.org/10.11648/j.ejcbs.20220801.11

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    ACS Style

    Collins Amadi; Stephenson Lawson. The Impact of Systemic Inflammation on Sex-based Bias Following SARS-CoV-2 Infection. Eur. J. Clin. Biomed. Sci. 2022, 8(1), 1-8. doi: 10.11648/j.ejcbs.20220801.11

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    AMA Style

    Collins Amadi, Stephenson Lawson. The Impact of Systemic Inflammation on Sex-based Bias Following SARS-CoV-2 Infection. Eur J Clin Biomed Sci. 2022;8(1):1-8. doi: 10.11648/j.ejcbs.20220801.11

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  • @article{10.11648/j.ejcbs.20220801.11,
      author = {Collins Amadi and Stephenson Lawson},
      title = {The Impact of Systemic Inflammation on Sex-based Bias Following SARS-CoV-2 Infection},
      journal = {European Journal of Clinical and Biomedical Sciences},
      volume = {8},
      number = {1},
      pages = {1-8},
      doi = {10.11648/j.ejcbs.20220801.11},
      url = {https://doi.org/10.11648/j.ejcbs.20220801.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20220801.11},
      abstract = {Background: The unfavorable clinical outcome (higher rates of severity/morbidity/mortality) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a disproportionate bias towards the male sex despite no sex-based difference noted in the risk for the infection. These outcomes have widely been hinged on dysregulated systemic inflammation. Hence, this study was aimed to evaluate the influence of systemic inflammation on sex-based bias in SARS-CoV-2 infection among indigenes of Nigerian Methods: Patients’ data with positive real-time polymerase chain reaction (RT-PCR) test for coronavirus disease 2019 (COVID-19), who were admitted/managed at the Eleme treatment center in Port Harcourt, southern Nigeria, were enrolled for this study. All relevant data was acquired from archived case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using validated data collection templates. All the collated/abstracted data were analyzed/compared between the male and female patients using both descriptive and comparative statistical tools. Results A total of eligible 598 patients were included in the analysis among them 373 (62.4%) and 225 (37.6%) males and females, respectively. The males were much older (43.63±5.93 vs. 41.15±6.09; p<0.036) with higher mean body mass index and body temperature at presentation. Significant differences were observed in terms of the age distribution, occupational, educational, marital, residential status, cigarette smoking, alcohol consumption, body mass index, comorbid, severity, and clinical outcomes between the males and females (<0.05). In addition, the males had significantly higher mean levels of creatinine, C-reactive protein (CRP), Glasgow Prognostic Score (GPS), D-dimer, total WBC, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR) but lower levels of albumin, total protein, isolated platelet count, and isolated lymphocyte count (p<0.05). The males maintained a significant linear relationship with the CRP (β: 0.61; SE: 0.13; p<0.001), composite GPS (β: 0.59; SE: 0.01; p<0.001), D-dimer (β: 0.52; SE: 0.09; p<0.001), and the composite NLR (β: 0.38; SE: 0.10; p<0.001) compare to their female counterparts. Additionally, CRP (OR: 8.86; 95%CI: 7.34-9.78; p<0.001), the composite GPS (OR: 7.41; 95%CI: 6.36-8.79; p<0.001), D-dimer (OR: 5.4; 95%CI: 4.32-6.65), and the composite NLR (OR: 4.23; 95%CI: 3.44-5.69; p<0.001) all had significant and robust associations with unfavorable clinical outcomes among the males compared to the females. Conclusion: Exaggerated systemic inflammatory markers/indices were more pronounced among the males in association with unfavorable clinical outcomes. These sex-based characteristics should be factored in during the management of SARS-CoV-2 infection. However, further studies are recommended to evaluate conclusions from the current study.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - The Impact of Systemic Inflammation on Sex-based Bias Following SARS-CoV-2 Infection
    AU  - Collins Amadi
    AU  - Stephenson Lawson
    Y1  - 2022/02/09
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ejcbs.20220801.11
    DO  - 10.11648/j.ejcbs.20220801.11
    T2  - European Journal of Clinical and Biomedical Sciences
    JF  - European Journal of Clinical and Biomedical Sciences
    JO  - European Journal of Clinical and Biomedical Sciences
    SP  - 1
    EP  - 8
    PB  - Science Publishing Group
    SN  - 2575-5005
    UR  - https://doi.org/10.11648/j.ejcbs.20220801.11
    AB  - Background: The unfavorable clinical outcome (higher rates of severity/morbidity/mortality) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a disproportionate bias towards the male sex despite no sex-based difference noted in the risk for the infection. These outcomes have widely been hinged on dysregulated systemic inflammation. Hence, this study was aimed to evaluate the influence of systemic inflammation on sex-based bias in SARS-CoV-2 infection among indigenes of Nigerian Methods: Patients’ data with positive real-time polymerase chain reaction (RT-PCR) test for coronavirus disease 2019 (COVID-19), who were admitted/managed at the Eleme treatment center in Port Harcourt, southern Nigeria, were enrolled for this study. All relevant data was acquired from archived case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using validated data collection templates. All the collated/abstracted data were analyzed/compared between the male and female patients using both descriptive and comparative statistical tools. Results A total of eligible 598 patients were included in the analysis among them 373 (62.4%) and 225 (37.6%) males and females, respectively. The males were much older (43.63±5.93 vs. 41.15±6.09; p<0.036) with higher mean body mass index and body temperature at presentation. Significant differences were observed in terms of the age distribution, occupational, educational, marital, residential status, cigarette smoking, alcohol consumption, body mass index, comorbid, severity, and clinical outcomes between the males and females (<0.05). In addition, the males had significantly higher mean levels of creatinine, C-reactive protein (CRP), Glasgow Prognostic Score (GPS), D-dimer, total WBC, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR) but lower levels of albumin, total protein, isolated platelet count, and isolated lymphocyte count (p<0.05). The males maintained a significant linear relationship with the CRP (β: 0.61; SE: 0.13; p<0.001), composite GPS (β: 0.59; SE: 0.01; p<0.001), D-dimer (β: 0.52; SE: 0.09; p<0.001), and the composite NLR (β: 0.38; SE: 0.10; p<0.001) compare to their female counterparts. Additionally, CRP (OR: 8.86; 95%CI: 7.34-9.78; p<0.001), the composite GPS (OR: 7.41; 95%CI: 6.36-8.79; p<0.001), D-dimer (OR: 5.4; 95%CI: 4.32-6.65), and the composite NLR (OR: 4.23; 95%CI: 3.44-5.69; p<0.001) all had significant and robust associations with unfavorable clinical outcomes among the males compared to the females. Conclusion: Exaggerated systemic inflammatory markers/indices were more pronounced among the males in association with unfavorable clinical outcomes. These sex-based characteristics should be factored in during the management of SARS-CoV-2 infection. However, further studies are recommended to evaluate conclusions from the current study.
    VL  - 8
    IS  - 1
    ER  - 

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Author Information
  • Department of Chemical Pathology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria

  • Department of Medical Microbiology and Parasitology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria

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