Quality of Life in Post-COVID-19 Patients after Hospitalization

The COVID-19 pandemic has had a strong impact on people’s quality of life (QoL), which is affected by social and economic changes as well as by mental and physical health. The aim of this study was to determine QoL in post-COVID-19 patients who had required hospitalization, and to identify relevant sociodemographic data. We used questionnaires which considered demographic and socioeconomic data, health and vaccination status, the pandemic situation, and EQ-5D scoring. The interactions of all data and the scores of EQ-5D were analyzed. Multivariate logistic regression analysis was applied to the five dimensions of EQ-5D. In this single-hospital-cohort study, the average times elapsed since initial diagnosis and hospital admission were 2.5 (76.3 ± 18.1 days) and 5 months (155.4 ± 33.9 days), respectively. Post-COVID-19 females were 3–5 times more likely to be affected in terms of anxiety/depression, and in negative impact upon their usual activities, at 5 months after diagnosis. At the same time, reductions in mobility were 3–4 times more likely in elderly post-COVID-19 patients, whose levels of pain and discomfort increased. Single patients, those with low incomes, and those with severe clinical outcomes were 2–4 times more likely to experience a reduction in their usual activities, while the presence of co-morbidities and lower levels of education were associated with increased pain and discomfort. Aging-induced pain/discomfort and anxiety/depression were significantly exacerbated in elderly patients with widespread vaccination. Our study revealed effects of demographic and socioeconomic factors upon lower QoL in post-COVID-19 patients in four dimensions of EQ-5D: mobility, usual activity, pain/discomfort, and anxiety/depression, 5 months after first diagnosis and hospitalization

Androgen Dependence in Thrombosis of Patients With COVID-19

Background. A vascular system inflammation is a risk of venous thromboembolism and can result in widespread microangiopathy with microvascular thrombosis. Methods. We performed laboratory clinical follow-up of patients with COVID-19 to compare gender differences. To study the sex difference in COVID-19 outcome we will measure estradiol and androgens: dihydrotestosterone (DHT) and sex hormone binding globulin (SHBP) in plasma of 63 COVID-19 patients, analyzed by ELISA. Their levels will be correlated to the adhesion molecules: soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular adhesion molecule 1 (sVCAM-1), sE-selectin, and sP-selectin as biomarkers for inflammation and thrombosis. Results. DHT was increased (1.9 fold) in male COVID-19 patients compared to healthy male volunteers. SHBP was significantly increased in COVID-19 patients compared to healthy volunteers (p<0.05) as well as female vs. male COVID-19 patients (p<0.001, 2.5 fold). sVCAM-1 and sICAM-1 were increased in female COVID-19 patients compared to male COVID-19 patients and female volunteers, respectively (p<0.05). The sP-selection was significantly (p<0.01) increased in male vs. female COVID-19 patients. SHBP was in negative correlation with sP-selectin (p<0.05). DHT was in positive correlation with sVCAM-1 (p<0.05). Ferritin had 3-fold higher levels in male than female COVID-19 patients (p<0.001). Conclusions. Upregulation of androgen hormones and thrombotic biomarkers in COVID-19 patients demonstrate sex dependence

Gender Difference in SARS-CoV-2 Stimulation of Hyperinflammatory Response in Patients with COVID-19

Background: Although women and men have the same prevalence, men with COVID-19 are more at risk for worse outcomes and death, independent of age. Methods: To observe the hyperinflammatory response regarding sex, we will measure the levels of inflammatory cytokines: interleukin-6 (IL-6), IL-1β, tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), IL-10, interferon- gamma (IFN-γ), IL-8, transforming growth factor-beta 1 (TGF-β1), analyzed by ELISA, in plasma of 130 COVID-19 patients at diagnosis and correlate them with clinical parameters. Besides, we checked the quality of life of patients up to 3 months after hospitalization. Results: Pro-inflammatory IL-6 was significantly (p<0.01) increased in male COVID-19 patients compared to healthy male volunteers (4.7-fold) and female COVID-19 patients (1.75-fold). IL-6 was positively correlated to INR, aPTT (p<0.001), and ferritin (p<0.05), while INR with CRP (p<0.05). IL-8 was significantly increased in female COVID-19 patients compared to healthy female volunteers (p<0.01, 2.5-fold) and male COVID-19 patients (p<0.05). TNF-α was significantly (p<0.05) increased in male COVID-19 patients compared to healthy male volunteers. MCP-1 and IFN-γ were significantly increased in female COVID-19 patients compared to healthy female volunteers (p<0.01). Anti-inflammatory TGF-β1 was decreased in COVID-19 patients regardless of gender. Most patients were men (75%) with chronic disorders (59%, mostly hypertension). COVID-19 reduced their social (32%) and physical activities (34%) after 6 weeks of diagnosis, but further on reduced in additional 3 months (social 55%) with depression (22%). Conclusions: Inflammatory response is generally increased in COVID-19 patients with specific cytokines in accordance with gender

Sex Differences and Cytokine Profiles among Patients Hospitalized for COVID-19 and during Their Recovery: The Predominance of Adhesion Molecules in Females and Oxidative Stress in Males

The severity and mortality of coronavirus disease 2019 (COVID-19) are greater in males than in females, though the infection rate is the same in the two sexes. We investigated sex hormone differences associated with the hyperinflammatory immune response to SARS-CoV-2 on the basis of patients’ cytokine profiles and vaccination statuses. Clinical and laboratory data of 117 patients with COVID-19 were collected to examine sex differences associated with oxidative stress markers, neutrophil extracellular traps (NETs), and plasma cytokine levels up to 5 months from hospital admission. The testosterone and free testosterone levels were low in male patients with COVID-19 and returned to normal values after recovery from the disease. The dihydrotestosterone (DHT) levels were transiently reduced, while the sex hormone-binding globulin levels were decreased in post-COVID-19 male patients. The levels of the inflammatory cytokines interleukin-6 (IL-6) and IL-10 appeared generally increased at diagnosis and decreased in post-COVID-19 patients. In females, the concentration of tumor necrosis factor-alpha was increased by four times at diagnosis. The levels of the coagulation markers intercellular adhesion molecule-1 (ICAM-1) and E-selectin were consistently upregulated in post-COVID-19 female patients, in contrast to those of vascular cell adhesion molecule-1 (VCAM-1), P-selectin, and chemokine IL-8. DHT increased the levels of reactive oxygen species in the neutrophils of male patients, while estradiol decreased them in females. Markers for NET, such as circulating DNA and myeloperoxidase, were significantly more abundant in the patients’ plasma. Sex hormones have a potential protective role during SARS-CoV-2 infection, which is weakened by impaired testosterone synthesis in men