JMIR Publications

ABSTRACT

Background:

A higher incidence of COVID-19 in males has been widely reported. However, whether clinical manifestations, comorbidities, severity, and outcome differ between males and females remains an area of active investigation.

Objective:

To compare the clinical features, comorbidities, severity, and outcome between male and female COVID-19 patients, Baghdad, Iraq, 2020.

Methods:

We performed a records-based cross-sectional study by extracting sociodemographic, clinical manifestations, severity, and outcome data from the records of COVID- 19 patients admitted to two COVID-19 hospitals in Baghdad, Iraq between June and August 2020.

Results:

We reviewed a total of 2111 patient records with a history of COVID-19, and 1175 patients (55.7%) were males. We found that respiratory symptoms, sore throat, and gastrointestinal manifestations were significantly more common among females. In contrast, males had significantly higher “other” manifestations. No significant difference was noted for fever, nasal congestion, conjunctival congestion, headache, and musculoskeletal manifestations. Generally, female patients had a significantly higher proportion of comorbidities than males (42.7% vs 36.0%; P=0.002). The proportion of severe and critical cases was not different between males and females. The mean time from diagnosis to the outcome was significantly longer in females (P=.034), but the duration of the hospital stay showed no significant difference between males and females. Finally, the case fatality ratio was higher in males (16.1%) than females (13.2%).

Conclusions:

Sex affects the clinical course and outcome of COVID-19 patients. Male patients may need more attention considering the higher case fatality ratio.