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Clinical characteristics and the times from symptoms\u2019 onset to admission, nasopharyngeal swab, and death were compared between sexes. Adjusted multivariate analysis was performed to identify the clinical features associated with male sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 32,938 COVID-19-related deaths that occurred in Italy, 3517 hospitalized and deceased individuals with COVID-19 (mean 78 \u00b1 12\u2009years, 33% women) were analyzed. At admission, men had a higher prevalence of ischemic heart disease (adj-OR = 1.76, 95% CI 1.39\u20132.23), chronic obstructive pulmonary disease (adj-OR = 1.7, 95% CI 1.29\u20132.27), and chronic kidney disease (adj-OR = 1.48, 95% CI 1.13\u20131.96), while women were older and more likely to have dementia (adj-OR = 0.73, 95% CI 0.55\u20130.95) and autoimmune diseases (adj-OR = 0.40, 95% CI 0.25\u20130.63), yet both sexes had a high level of multimorbidity. The times from symptoms\u2019 onset to admission and nasopharyngeal swab were slightly longer in men despite a typical acute respiratory illness with more frequent fever at the onset. Men received more often experimental therapy (adj-OR = 2.89, 95% CI 1.45\u20135.74) and experienced more likely acute kidney injury (adj-OR = 1.47, 95% CI 1.13\u20131.90).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Men and women dying with COVID-19 had different clinical manifestations and transitions of care. Identifying sex-specific features in individuals with COVID-19 and fatal outcome might inform preventive strategies.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13293-020-00334-3","type":"journal-article","created":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T09:03:30Z","timestamp":1602839010000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Sex differences in clinical phenotype and transitions of care among individuals dying of COVID-19 in 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