학술논문
Sex and Gender-Related Differences in COVID-19 Diagnoses and SARS-CoV-2 Testing Practices During the First Wave of the Pandemic: The Dutch Lifelines COVID-19 Cohort Study.
Document Type
Article
Author
Ballering, Aranka Viviënne; Oertelt-Prigione, Sabine; olde Hartman, Tim C.; Rosmalen, Judith G.M.; Boezen, Marike; Mierau, Jochen O.; Franke, Lude H.; Dekens, Jackie; Deelen, Patrick; Lanting, Pauline; Vonk, Judith M.; Nolte, Ilja; Ori, Anil P.S.; Claringbould, Annique; Boulogne, Floranne; Dijkema, Marjolein X.L.; Wiersma, Henry H.; Warmerdam, Robert; Jankipersadsing, Soesma A.
Source
Subject
*STATISTICS
*EVALUATION of medical care
*REVERSE transcriptase polymerase chain reaction
*COVID-19
*CONFIDENCE intervals
*MULTIPLE regression analysis
*SEX distribution
*EMPLOYMENT
*DESCRIPTIVE statistics
*COVID-19 testing
*POLYMERASE chain reaction
*SMOKING
*ODDS ratio
*COVID-19 pandemic
*LONGITUDINAL method
*COMORBIDITY
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Language
ISSN
1540-9996
Abstract
Background: Although sex differences are described in Coronavirus Disease 2019 (COVID-19) diagnoses and testing, many studies neglect possible gender-related influences. Additionally, research is often performed in clinical populations, while most COVID-19 patients are not hospitalized. Therefore, we investigated associations between sex and gender-related variables, and COVID-19 diagnoses and testing practices in a large general population cohort during the first wave of the pandemic when testing capacity was limited. Methods: We used data from the Lifelines COVID-19 Cohort (N = 74,722; 60.8% female). We applied bivariate and multiple logistic regression analyses. The outcomes were a COVID-19 diagnosis (confirmed by SARS-CoV-2 PCR testing or physician's clinical diagnosis) and PCR testing. Independent variables included among others participants' sex, age, somatic comorbidities, occupation, and smoking status. Sex-by-comorbidity and sex-by-occupation interaction terms were included to investigate sex differences in associations between the presence of comorbidities or an occupation with COVID-19 diagnoses or testing practices. Results: In bivariate analyses female sex was significantly associated with COVID-19 diagnoses and testing, but significance did not persist in multiple logistic regression analyses. However, a gender-related variable, being a health care worker, was significantly associated with COVID-19 diagnoses (OR = 1.68; 95%CI = 1.30–2.17) and testing (OR = 12.5; 95%CI = 8.55–18.3). Female health care workers were less often diagnosed and tested than male health care workers (ORinteraction = 0.54; 95%CI = 0.32–0.92, ORinteraction = 0.53; 95%CI = 0.29–0.97, respectively). Conclusions: We found no sex differences in COVID-19 diagnoses and testing in the general population. Among health care workers, a male preponderance in COVID-19 diagnoses and testing was observed. This could be explained by more pronounced COVID-19 symptoms in males or by gender inequities. [ABSTRACT FROM AUTHOR]