TY - JOUR T1 - Sex differences in cardiovascular complications and mortality in hospital patients with covid-19: registry based observational study JF - BMJ Medicine JO - bmjmed DO - 10.1136/bmjmed-2022-000245 VL - 2 IS - 1 SP - e000245 AU - Carinna Hockham AU - Marijke Linschoten AU - Folkert W Asselbergs AU - Chahinda Ghossein AU - Mark Woodward AU - Sanne A E Peters A2 - , Y1 - 2023/02/01 UR - http://bmjmedicine.bmj.com/content/2/1/e000245.abstract N2 - 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. ER -