442. Sex-Related Differences in Mortality from COVID-19: Survival Analysis of Patients from an Urban Hospital

Background Mortality from COVID-19 is associated with male sex, older age, black race, and comorbidities including obesity. Our study identified risk factors for in-hospital mortality from COVID-19 using survival analysis at an urban center in Detroit, MI. Methods This was a single-center historical cohort study. We reviewed the electronic medical records of patients positive for severe acute respiratory syndrome coronavirus 2 (the COVID-19 virus) on qualitative polymerase-chain-reaction assay, who were admitted between 3/8-6/14/20. We assessed risk factors for mortality using Kaplan-Meier analysis and Cox proportional hazards models. Results We included 565 patients with mean age (standard deviation) 64.4 (16.2) years, 52.0% male (294) and 77.2% (436) black/African American. The overall mean body mass index (BMI) was 32.0 (9.02) kg/m2. At least one comorbidity was present in 95.2% (538) of patients. The overall case-fatality rate was 30.4% (172/565). The unadjusted mortality rate among males was 33.7% compared to 26.9% in females (p=0.08); the median time to death (range) for males was 16.8 (0.3, 33.9) compared to 14.2 (0.32, 47.7) days for females (p=0.04). Univariable survival analysis with Cox proportional hazards models revealed that age (p=< 0.0001), admission from a facility (p=0.002), public insurance (p< 0.0001), respiratory rate ≥ 22 bpm (p=0.02), lymphocytopenia (p=0.07) and serum albumin (p=0.007) were additional risk factors for mortality (Table 1). From multivariable Cox proportional hazards modeling (Table 2), after controlling for age, Charlson score and qSofa, males were 40% more likely to die than females (p=0.03). Table 1. Univariate analysis with Cox proportional hazards model on factors associated with mortality in patients with COVID-19 Abbreviations: HR: Hazard ratio, CI: Confidence interval Table 2. Multivariable analysis with Cox proportional hazards model on factors associated with mortality in patients with COVID-19 Abbreviations: HR: Hazard ratio, CI: Confidence interval, CWIC: Charlson weighted index of comorbidity, qSOFA: Quick sepsis related organ failure assessment Conclusion After controlling for risk factors for mortality including age, comorbidity and sepsis-related organ failure assessment, males continued to have a higher hazard of death. These demographic and clinical factors may help healthcare providers identify risk factors from COVID-19. Disclosures All Authors: No reported disclosures