학술논문

Impact of sex and gender on post-COVID-19 syndrome, Switzerland, 2020.
Document Type
Academic Journal
Author
Gebhard CE; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; These authors contributed equally.; Sütsch C; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; These authors contributed equally.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Gebert P; Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.; Gysi B; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; Bengs S; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Todorov A; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Deforth M; Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.; Buehler PK; Institute of Intensive Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Meisel A; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Schuepbach RA; Institute of Intensive Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Zinkernagel AS; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Brugger SD; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Acevedo C; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Patriki D; Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.; Wiggli B; Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland.; Beer JH; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland.; Friedl A; Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland.; Twerenbold R; Department of Cardiology, University Hospital Basel, Basel, Switzerland.; Department of Cardiology and University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, Hamburg, Germany.; Kuster GM; Department of Cardiology, University Hospital Basel, Basel, Switzerland.; Department of Biomedicine, University of Basel, Basel, Switzerland.; Pargger H; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; Tschudin-Sutter S; Division of Infectious Diseases and Hospital Epidemiology, University of Basel, Basel, Switzerland.; Schefold JC; Department of Intensive Care Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.; Spinetti T; Department of Intensive Care Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.; Henze C; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Pasqualini M; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Sager DF; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Mayrhofer L; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; Grieder M; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; Tontsch J; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; Franzeck FC; Department of Informatics, University Hospital Basel, Basel, Switzerland.; Wendel Garcia PD; Institute of Intensive Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Hofmaenner DA; Institute of Intensive Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Scheier T; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Bartussek J; Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland.; Institute of Intensive Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Haider A; Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, and Department of Radiology, Harvard Medical School, Boston, Massachusetts, United States.; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Grämer M; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Mikail N; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Rossi A; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Zellweger N; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; Opić P; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; Portmann A; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; von Känel R; Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Pazhenkottil AP; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Messerli M; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Buechel RR; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Kaufmann PA; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Treyer V; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Siegemund M; Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.; Held U; Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.; Regitz-Zagrosek V; Institute of Gender in Medicine (GiM), Charité - Universitätsmedizin Berlin, Berlin, Germany.; Gebhard C; Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.
Source
Publisher: European Centre for Disease Prevention and Control (ECDC) Country of Publication: Sweden NLM ID: 100887452 Publication Model: Print Cited Medium: Internet ISSN: 1560-7917 (Electronic) Linking ISSN: 1025496X NLM ISO Abbreviation: Euro Surveill Subsets: MEDLINE
Subject
Language
English
Abstract
BackgroundWomen are overrepresented among individuals with post-acute sequelae of SARS-CoV-2 infection (PASC). Biological (sex) as well as sociocultural (gender) differences between women and men might account for this imbalance, yet their impact on PASC is unknown.AimWe assessed the impact of sex and gender on PASC in a Swiss population.MethodOur multicentre prospective cohort study included 2,856 (46% women, mean age 44.2 ± 16.8 years) outpatients and hospitalised patients with PCR-confirmed SARS-CoV-2 infection.ResultsAmong those who remained outpatients during their first infection, women reported persisting symptoms more often than men (40.5% vs 25.5% of men; p < 0.001). This sex difference was absent in hospitalised patients. In a crude analysis, both female biological sex (RR = 1.59; 95% CI: 1.41-1.79; p < 0.001) and a score summarising gendered sociocultural variables (RR = 1.05; 95% CI: 1.03-1.07; p < 0.001) were significantly associated with PASC. Following multivariable adjustment, biological female sex (RR = 0.96; 95% CI: 0.74-1.25; p = 0.763) was outperformed by feminine gender-related factors such as a higher stress level (RR = 1.04; 95% CI: 1.01-1.06; p = 0.003), lower education (RR = 1.16; 95% CI: 1.03-1.30; p = 0.011), being female and living alone (RR = 1.91; 95% CI: 1.29-2.83; p = 0.001) or being male and earning the highest income in the household (RR = 0.76; 95% CI: 0.60-0.97; p = 0.030).ConclusionSpecific sociocultural parameters that differ in prevalence between women and men, or imply a unique risk for women, are predictors of PASC and may explain, at least in part, the higher incidence of PASC in women. Once patients are hospitalised during acute infection, sex differences in PASC are no longer evident.