RESUMO
AIM: To investigate how age, sex, and comorbidities affect the survival of hospitalized coronavirus disease 2019 (COVID-19) patients. METHODS: We retrospectively analyzed the records of 4014 consecutive adults hospitalized for COVID-19 in a tertiary-level institution from March 2020 to March 2021. RESULTS: The median age was 74 years. A total of 2256 (56.2%) patients were men. The median Charlson-comorbidity-index (CCI) was 4 points; 3359 (82.7%) patients had severe or critical COVID-19. A significant interaction between age, sex, and survival (P<0.05) persisted after adjustment for CCI. In patients <57 years, male sex was related to a favorable (odds ration [OR] 0.50, 95% confidence interval [CI] 0.29-0.86), whereas in patients ≥57 years it was related to an unfavorable prognosis (OR 1.19, 95% CI 1.04-1.37). Comorbidities associated with inferior survival independently of age, sex, and severe/critical COVID-19 on admission were chronic heart failure, atrial fibrillation, acute myocardial infarction, acute cerebrovascular insult, history of venous thromboembolism, chronic kidney disease, major bleeding, liver cirrhosis, mental retardation, dementia, active malignant disease, metastatic malignant disease, autoimmune/rheumatic disease, bilateral pneumonia, and other infections on admission. CONCLUSION: Among younger patients, female sex might lead to an adverse prognosis due to undisclosed reasons (differences in fat tissue distribution, hormonal status, and other mechanisms). Patient subgroups with specific comorbidities require additional considerations during hospital stay for COVID-19. Future studies focusing on sex differences and potential interactions are warranted.
Assuntos
COVID-19 , Adulto , Idoso , COVID-19/epidemiologia , Comorbidade , Feminino , Hospitalização , Humanos , Masculino , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2RESUMO
Oral cavity and perioral area are constantly exposed to a variety of antigens, including food and additives, which have a potential role in the development of different oral mucosal and perioral cutaneous diseases since they can cause hypersensitivity reactions. Oral and perioral diseases mainly include angioedema, burning mouth syndrome, cheilitis, gingivostomatitis, oral lichenoid reactions, and perioral dermatitis. Previous studies were focused on delayed-type oral allergies by performing patch testing but did not include tests for immediate-type allergic reactions. Therefore, the objective of this study was to determine common nutritive and additive allergens in the prevalent oral and perioral diseases by using skin prick tests. Our study evaluated 230 participants, i.e. 180 patients with oral/perioral diseases (angioedema, burning mouth syndrome, cheilitis, gingivostomatitis, oral lichenoid reactions, and perioral dermatitis), and 50 healthy control subjects. The results of skin prick tests showed that immediate-type allergic reactions to food and additives were mostly seen in patients with burning mouth syndrome (40%) and cheilitis (33.3%), whereas allergies were least frequently observed in perioral dermatitis (10%) and gingivostomatitis (20%). Fruits, mushrooms, and vegetables were the most frequent causes of nutritive allergies in oral and perioral diseases. The most commonly identified additive allergens were glutaraldehyde, citric acid, and sodium glutamate. Study results suggest the possible association with nutritive and additive allergies be considered in cases of persistent oral mucosal or perioral skin disease accompanied by respective medical history.