Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry

BACKGROUND: The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex. OBJECTIVE: To compare clinical...

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Autores principales: Frank Cañón-Estrada, Juan Andrés Muñoz-Ordoñez, Manuela Escalante‐Forero, Yorlany Rodas, Andrea Alejandra Arteaga-Tobar, Valeria Azcárate-Rodríguez, Eduardo Perna, Iván Mendoza, Fernando Wyss, José Luis Barisani, Mario Speranza, Walter Alarco, Juan Carlos Barrera Ortega, Andrés Ulate, Jessica Mercedes, Daniel Quesada, Paola Oliver, Andrea Valencia‐Orozco, Mario Miguel Barbosa, Hoover León-Giraldo, Noel Flórez, Juan Esteban Gómez‐Mesa, María Lorena Coronel, Alejandra Christen, Paula Alexandra Silva, Juan Martín Brunialti, Pedro Vellosa Schwartzmann, Luis Carlos Santana Passos, Estêvão Lanna Figueiredo, Carlos Eduardo Lucena Montenegro, Franco Appiani Florit, Ricardo Enrique Larrea Gómez, Fernando Verdugo Thomas, Iván Criollo, Ricardo Ramírez, Víctor Rossel, Julián Lugo, Hugo Fernández, María José Sanjinés Rodríguez, Andrés F. Buitrago, Juan Isaac Ortíz, William Millán Orozco, Clara Saldarriaga, Sylvia Sandoval, Liliana Patricia Cárdenas Aldaz, Marlon Aguirre, Fei Chong, Armando Alvarado, Daniel Sierra, Alexander Romero, Miguel Quintana, Felipe Nery Gervacio Fernández, R. Correa, Francisco Chávez Sol Sol, Wilbert German Yabar Galindo, Claudia Almonte, César J. Herrera, Igor Morr, Eglee Castillo
Formato: Artículo
Lenguaje:inglés
Publicado: 2025
Materias:
Medicine
Angiology
Internal medicine
Biomarker
Procalcitonin
Pulmonary embolism
Intensive care unit
Ferritin
Population
Heart failure
Cardiology
Sepsis
Environmental health
Biochemistry
Chemistry
COVID-19 blood
COVID-19 diagnosis
COVID-19 mortality
COVID-19 epidemiology
COVID-19 therapy
SARS-CoV-2
Aged
C-Reactive Protein analysis
C-Reactive Protein metabolism
Female
Ferritins blood
Fibrin Fibrinogen Degradation Products analysis
Hospitalization
Humans
Latin America epidemiology
Male
Middle Aged
Prognosis
Prospective Studies
Registries
Risk Factors
Sex Factors
Biomarkers blood
Cluster Analysis
Caribbean Region epidemiology
Health Sciences Medicine Infectious Diseases COVID-19 Clinical Research Studies
Health Sciences Medicine Neurology Long-Term Effects of COVID-19
Health Sciences Medicine Infectious Diseases SARS-CoV-2 and COVID-19 Research
Acceso en línea:Ver en el sistema de origen
Ver en el sistema de origen
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Sumario:BACKGROUND: The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex. OBJECTIVE: To compare clinical data, biochemical biomarkers, and outcomes among hospitalized COVID-19 patients in Latin America and the Caribbean (LA&C) based on sex and to perform a cluster analysis of biomarker profiles for both sexes. METHODS: This prospective, multicenter observational registry made by the Inter-American Council of Heart Failure and Pulmonary Hypertension of the Inter-American Society of Cardiology included hospitalized COVID-19 patients from 44 hospitals in 14 countries in LA&C between May 1, 2020, and June 30, 2021. RESULTS: Of 3,260 patients (1,201 females and 2,059 males), males had higher C-reactive protein and ferritin levels, while females had higher natriuretic peptides and d-dimer levels. Males had more cardiovascular complications (acute coronary syndrome [3.3% vs. 2.2%], decompensated heart failure [8.9% vs. 7.8%], pulmonary embolism [4.4% vs. 2.9%]), intensive care unit (ICU) admissions (56.9% vs. 47.7%), and overall mortality (27.5% vs. 22.1%). Cluster analysis identified three groups: one with normal-range biomarkers but elevated ferritin, one with coagulation abnormalities, and one with an inflammatory profile linked to renal injury and increased non-cardiovascular mortality. CONCLUSIONS: In the LA&C population hospitalized with COVID-19, males had higher inflammatory biomarker levels, correlating with increased cardiovascular complications and mortality. The cluster with an inflammatory profile showed higher non-cardiovascular mortality, while clusters with elevated ferritin levels were associated with increased ICU admissions.

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