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Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry
Author(s)
Icesi University
Juan Andrés Muñoz-Ordoñez
Icesi University
Manuela Escalante‐Forero
Icesi University
Yorlany Rodas
Fundación Valle del Lili
Andrea Alejandra Arteaga-Tobar
Icesi University
Valeria Azcárate-Rodríguez
Icesi University
Eduardo Perna
Iván Mendoza
Central University of Venezuela
Fernando Wyss
José Luis Barisani
Mario Speranza
Walter Alarco
EsSALUD
Juan Carlos Barrera Ortega
Andrés Ulate
Jessica Mercedes
Daniel Quesada
Paola Oliver
Andrea Valencia‐Orozco
Fundación Valle del Lili
Mario Miguel Barbosa
Fundación Valle del Lili
Hoover León-Giraldo
Fundación Valle del Lili
Noel Flórez
Fundación Valle del Lili
Juan Esteban Gómez‐Mesa
Fundación Valle del Lili
María Lorena Coronel
Alejandra Christen
Paula Alexandra Silva
Juan Martín Brunialti
Pedro Vellosa Schwartzmann
Luis Carlos Santana Passos
Estêvão Lanna Figueiredo
Carlos Eduardo Lucena Montenegro
Franco Appiani Florit
Ricardo Enrique Larrea Gómez
Fundación Valle del Lili
Fernando Verdugo Thomas
Iván Criollo
Central University of Venezuela
Ricardo Ramírez
Víctor Rossel
Julián Lugo
María José Sanjinés Rodríguez
Icesi University
Andrés F. Buitrago
Noel Flórez
Fundación Valle del Lili
Juan Isaac Ortíz
William Millán Orozco
Fundación Valle del Lili
Clara Saldarriaga
Daniel Quesada
Sylvia Sandoval
Liliana Patricia Cárdenas Aldaz
Marlon Aguirre
Fei Chong
Armando Alvarado
Daniel Sierra
Alexander Romero
Miguel Quintana
Fundación Valle del Lili
Felipe Nery Gervacio Fernández
R. Correa
Francisco Chávez Sol Sol
Wilbert German Yabar Galindo
Claudia Almonte
César J. Herrera
Igor Morr
Eglee Castillo
Date Issued
5 de marzo de 2025
Type
Article
Volume
25
Issue
1
Series/Report No.
BMC Cardiovascular Disorders
Start Page
147
End Page
147
ISSN
1471-2261
Abstract
BACKGROUND: The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex. OBJECTIVE: To compare clinical data, biochemical biomarkers, and outcomes among hospitalized COVID-19 patients in Latin America and the Caribbean (LA&C) based on sex and to perform a cluster analysis of biomarker profiles for both sexes. METHODS: This prospective, multicenter observational registry made by the Inter-American Council of Heart Failure and Pulmonary Hypertension of the Inter-American Society of Cardiology included hospitalized COVID-19 patients from 44 hospitals in 14 countries in LA&C between May 1, 2020, and June 30, 2021. RESULTS: Of 3,260 patients (1,201 females and 2,059 males), males had higher C-reactive protein and ferritin levels, while females had higher natriuretic peptides and d-dimer levels. Males had more cardiovascular complications (acute coronary syndrome [3.3% vs. 2.2%], decompensated heart failure [8.9% vs. 7.8%], pulmonary embolism [4.4% vs. 2.9%]), intensive care unit (ICU) admissions (56.9% vs. 47.7%), and overall mortality (27.5% vs. 22.1%). Cluster analysis identified three groups: one with normal-range biomarkers but elevated ferritin, one with coagulation abnormalities, and one with an inflammatory profile linked to renal injury and increased non-cardiovascular mortality. CONCLUSIONS: In the LA&C population hospitalized with COVID-19, males had higher inflammatory biomarker levels, correlating with increased cardiovascular complications and mortality. The cluster with an inflammatory profile showed higher non-cardiovascular mortality, while clusters with elevated ferritin levels were associated with increased ICU admissions.
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