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Evidence of gender bias in the diagnosis and management of covid-19 patients: a big data analysis of electronic health records

J. Ancochea, Jose L. Izquierdo, I. H. Medrano, A. Porras, M. Serrano, S. Lumbreras, C. del Río-Bermúdez, S. Marchesseau, I. Salcedo, I. Zubizarreta, Y. González, Joan B. Soriano

Background:: It remains unknown whether the frequency and severity of COVID-19 affect women differently than men. Here, we aim to describe the characteristics of COVID-19 patients at disease onset, with a special focus on the diagnosis and management of female patients with COVID- 19.

Methods: We explored the electronic health records within a free-for-all, universal healthcare of 1,446,452 patients from January 1st to May 1st, 2020. We extracted clinical information upon diagnosis, progression, and outcome for all COVID-19 cases.

Results: A total of 4,780 patients with a test-confirmed diagnosis of COVID-19 were identified. Of these, 2,443 (51%) were female, who were on average 1.5 years younger than males (61.7±19.4 vs. 63.3±18.3, p=0.0025). There were more female COVID-19 cases in the 15-59 yr.-old interval, with the greatest sex ratio (SR; 95% CI) observed in the 30-39 yr.-old interval (1.69; 1.35-2.11). Upon diagnosis, headache, anosmia, and ageusia were significantly more frequent in females than males. Imaging by chest X-ray or blood tests were performed less frequently in females (65.5% vs. 78.3% and 49.5% vs.63.7%, respectively), all p<0.001. Regarding hospital resource use, females showed less frequency of hospitalization (44.3% vs. 62.0%) and ICU admission (2.8% vs. 6.3%) than males, all p<0.001.

Conclusion: In this clinical series of COVID-19 patients, 51% were female. Female teens and young adults suffered from COVID-19 more frequently than their male counterparts. Headache as well as ear, nose and throat (ENT) symptoms were significantly more frequent in female COVID-19 patients, although hospitalization and ICU admission were less common outcomes.


Keywords: epidemiology

Fecha de Registro: 2020-07-20

IIT-20-081A


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