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ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1536627
This article is part of the Research Topic The Impact of Sex and Gender in Disease Diagnostics in Global Health View all articles
Sex differences in the association between preexisting comorbidities and COVID-19-related symptoms during the COVID-19 pandemic in the Dominican Republic
Provisionally accepted
Shu-Hui Wen 1
Beatrice Chakanika 1 Nelson Martínez Rodríguez 2 Katherine Victorio Suberví 2 Julia Pérez Rodríguez 2 Lih-Ming Yiin 1
Chia-Jung Hsieh 1*- 1 Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan
- 2 Health Research Directorate, Ministry of Public Health, Santo Domingo, Dominican Republic
Background: Sex-based differences in the impact of comorbidities on coronavirus disease 2019 (COVID-19) related symptoms remain underexplored due to the predominance of sex-aggregated data. We aimed to examine sex differences in the associations between preexisting comorbidities and COVID-19-related symptoms during the COVID-19 pandemic in the Dominican Republic. Methods: We conducted a cross-sectional study using a questionnaire survey in the Dominican Republic between September 2021 and December 2021. Data on demographic factors, preexisting comorbidities, and self-reported COVID-19-related symptoms were collected. A multiple logistic regression model was used to separately identify associations between preexisting comorbidities and COVID-19-related symptoms in males and females. Results: We included a total of 3,308 eligible individuals.Approximately 25% of the participants had preexisting comorbidities, and 31% of the participants experienced COVID-19-related symptoms. Multiple logistic regression analyses revealed that asthma (OR= 2.15, 95% CI= 1.20-3.85, p= 0.01) was associated with the presence of COVID-19-related symptoms in males. For females, chronic lung disease (OR= 5.39, 95% CI=1.52-19.18, p= 0.009), hypertension (OR= 1.33, 95% CI=1.00-1.77, p=0.047) and diabetes mellitus (OR=1.70, 95% CI=1.07-2.71, p= 0.025) were correlated with COVID-19-related symptoms. Conclusions: Our study findings observe sex differences sex-differences in the associations between preexisting comorbidities and COVID-19-related symptoms. Specifically, we observed that male individuals with asthma and females with chronic lung disease, hypertension, and diabetes mellitus had a greater likelihood of experiencing COVID-19-related symptoms. Future studies are needed to confirm the mechanism underlying these sex differences.
Keywords: No. 701, Sec. 3, Zhongyang Rd., Hualien City, Hualien County 970, Taiwan asthma, chronic lung disease, Hypertension
Received: 29 Nov 2024; Accepted: 05 Mar 2025.
Copyright: © 2025 Wen, Chakanika, Martínez Rodríguez, Suberví, Pérez Rodríguez, Yiin and Hsieh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Chia-Jung Hsieh, Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan
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