@article {Hockhame000245, author = {Carinna Hockham and Marijke Linschoten and Folkert W Asselbergs and Chahinda Ghossein and Mark Woodward and Sanne A E Peters}, editor = {, and , and Al-Ali, AK and Al-Muhanna, FA and Al-Windy, NYY and Almubarak, YA and Alnafie, AN and Alshahrani, M and Alshehri, AM and Anthonio, RL and Asselbergs, FW and Aujayeb, A and ten Berg, JM and van Boxem, AJM and Captur, G and Caputo, M and Charlotte, N and Dark, P and De Sutter, J and Delsing, CE and Dorman, HGR and Drost, JT and Emans, ME and Ferreira, JB and Gabriel, L and van Gilst, WH and Groenemeijer, BE and Haerkens-Arends, HE and van der Harst, P and Hedayat, B and van der Heijden, DJ and Hellou, E and Hermanides, RS and Hermans-van Ast, JF and van Hessen, MWJ and Heymans, SRB and van der Horst, ICC and van Ierssel, SH and Jewbali, LS and Kearney, MT and van Kesteren, HAM and BLJH, Kietselaer and Koning, AMH and Kopylov, PY and Kuijper, AFM and Kwakkel-vanErp, JM and Linden MMJM, van der and Linschoten, M and Linssen, GCM and Ruiz R, Macias and Magdelijns, FJH and FMAC, Martens and McCann, GP and van der Meer, P and Meijs, MFL and Messiaen, P and Monraats, PS and Montagna, L and Moriarty, A and Mosterd, A and Nierop, PR and van Ofwegen-Hanekamp, CEE and Pinto, YM and Poorhosseini, H and Prasad, S and Red{\'o}n, J and Reidinga, AC and Ribeiro, MIA and Ripley, DP and Salah, R and Saneei, E and Saxena, M and Schaap, J and DAAM, Schellings and Schut, A and Shafiee, A and Shore, AC and Siebelink, HJ and van Smeden, M and Smits, PC and Pisters, R and Tessitore, E and Tieleman, RG and Timmermans, P and Tio, RA and Tjong, FVY and den Uil, CA and Van Craenenbroeck, EM and HPAA, van Veen and Veneman, T and Verschure, DO and de Vries, JK and van de Wal, RMA and van de Watering, DJ and Westendorp, ICD and Westendorp, PHM and Weytjens, C and Wierda, E and Williams, B and Woudstra, P and Wu, KW and Zaal, R and Zaman, AG and van derZee, PM}, title = {Sex differences in cardiovascular complications and mortality in hospital patients with covid-19: registry based observational study}, volume = {2}, number = {1}, elocation-id = {e000245}, year = {2023}, doi = {10.1136/bmjmed-2022-000245}, publisher = {BMJ Specialist Journals}, abstract = {Objective To assess whether the risk of cardiovascular complications of covid-19 differ between the sexes and to determine whether any sex differences in risk are reduced in individuals with pre-existing cardiovascular disease.Design Registry based observational study.Setting 74 hospitals across 13 countries (eight European) participating in CAPACITY-COVID (Cardiac complicAtions in Patients With SARS Corona vIrus 2 regisTrY), from March 2020 to May 2021Participants All adults (aged >=18 years), predominantly European, admitted to hospital with highly suspected covid-19 disease or covid-19 disease confirmed by positive laboratory test results (n=11 167 patients).Main outcome measures Any cardiovascular complication during admission to hospital. Secondary outcomes were in-hospital mortality and individual cardiovascular complications with >=20 events for each sex. Logistic regression was used to examine sex differences in the risk of cardiovascular outcomes, overall and grouped by pre-existing cardiovascular disease.Results Of 11 167 adults (median age 68 years, 40\% female participants) included, 3423 (36\% of whom were female participants) had pre-existing cardiovascular disease. In both sexes, the most common cardiovascular complications were supraventricular tachycardias (4\% of female participants, 6\% of male participants), pulmonary embolism (3\% and 5\%), and heart failure (decompensated or de novo) (2\% in both sexes). After adjusting for age, ethnic group, pre-existing cardiovascular disease, and risk factors for cardiovascular disease, female individuals were less likely than male individuals to have a cardiovascular complication (odds ratio 0.72, 95\% confidence interval 0.64 to 0.80) or die (0.65, 0.59 to 0.72). Differences between the sexes were not modified by pre-existing cardiovascular disease; for the primary outcome, the female-to-male ratio of the odds ratio in those without, compared with those with, pre-existing cardiovascular disease was 0.84 (0.67 to 1.07).Conclusions In patients admitted to hospital for covid-19, female participants were less likely than male participants to have a cardiovascular complication. The differences between the sexes could not be attributed to the lower prevalence of pre-existing cardiovascular disease in female individuals. The reasons for this advantage in female individuals requires further research.Data are available upon reasonable request. The data used in this study might be available from the CAPACITY-COVID Collaborative Consortium. Researchers who are interested in investigating the role of cardiovascular disease in the covid-19 pandemic can apply for data access approval by the CAPACITY data access committee. The programming code developed for this study is available on reasonable request.}, URL = {https://bmjmedicine.bmj.com/content/2/1/e000245}, eprint = {https://bmjmedicine.bmj.com/content/2/1/e000245.full.pdf}, journal = {BMJ Medicine} }