Women Hospitalized With COVID-19 at Higher Risk for AHF Than Men

In patients hospitalized for COVID-19, compared with men, women have a higher risk for acute heart failure and in-hospital mortality.

In general wards, women are at increased risk for acute heart failure (AHF) and in-hospital mortality from COVID-19 compared with men, according to study results presented at the American College of Cardiology (ACC) 2023 conference, held from March 4 to 6, 2023, in New Orleans, Louisiana.

Differences in mortality from COVID-19 have been observed between men and women. However, to date, little is known about differences in organ-specific dysfunction between genders.

In this study, investigators from the University of Bologna in Italy retrospectively evaluated patient data collected between March 2020 and February 2022 at 17 hospitals in 5 European countries that were participating in the International Survey of Acute Coronavirus Syndrome (ISACS; ClinicalTrials.gov Identifier: NCT05188612). The outcomes of interest were acute respiratory failure, AHF, acute kidney injury (AKI), and in-hospital mortality.

A total of 4499 patients were hospitalized with COVID-19, among whom 33.9% were admitted to the ICU and 24.8% died in-hospital.

Equitable access to COVID-19 ICU care is needed to minimize the unfavorable outcome of women presenting with COVID-19 related complications.

Among all patients, a significant interaction was observed (P =.04), in which women (adjusted risk ratio [aRR], 1.13; 95% CI, 0.90-1.42) were at higher risk for in-hospital mortality than men (aRR, 0.86-0.70-1.05).

In-hospital mortality was associated with developing acute respiratory failure (odds ratio [OR], 3.95; 95% CI, 3.04-5.14), AKI (OR, 3.85; 95% CI, 3.21-4.63), and AHF (OR, 2.27; 95% CI, 1.73-2.98).

Men and women were at similar risk for developing AKI and acute respiratory failure, regardless of ward placement. In contrast, women were at higher risk for AHF (RR, 1.25; 95% CI, 0.94-1.67) compared with men (RR, 0.83; 95% CI, 0.59-1.16) in general wards (Pinteraction =.04) but not in the ICU.

Women were less likely to be admitted to the ICU than men (RR, 0.80; 95% CI, 0.71-0.91).

“Women in general wards were at increased risk of AHF and in-hospital mortality for COVID-19 compared with men. For patients receiving ICU care, fatal complications including AHF, and mortality appeared to be independent of sex,” the study authors wrote. “Equitable access to COVID-19 ICU care is needed to minimize the unfavorable outcome of women presenting with COVID-19 related complications.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Cardiology Advisor


Cenko E, Bergami M, Zdravkovic M, et al. Sex differences and disparities in cardiovascular complications and intensive care unit admission associated with COVID-19. Abstract presented at: ACC 2023; March 4-6, 2023; New Orleans, LA. 1068-009.