Spain is one of the countries most affected by the COVID-19 pandemic. Although risk factors for severe disease are published, sex differences have been widely neglected. In this multicentre study, we aimed to identify predictors of in-hospital mortality in men and women hospitalised with COVID-19. An observational longitudinal study was conducted in the cohort of patients admitted to four hospitals in Andalusia, Spain, from 1 March 2020 to 15 April 2020. Sociodemographic and clinical data were collected from hospital records. The Kaplan–Meier method was used to estimate 30-day survival and multiple Cox regression models were applied. All analyses were stratified by sex. A total of 968 patients were included (54.8% men, median age 67.0 years). In-hospital mortality reached 19.1% in men and 16.0% in women. Factors independently associated with an increased hazard of death were advanced age, higher CURB-65 score and not receiving azithromycin treatment, in both sexes; active cancer and autoimmune disease, in men; cardiovascular disease and chronic lung disease, in women. Disease outcomes and predictors of death differed between sexes. In-hospital mortality was higher in men, but the long-term effects of COVID-19 merit further research. The sex-differential impact of the pandemic should be addressed in public health policies.

Background: Invasive meningococcal disease (IMD) can lead to severe and fatal outcomes. Vaccines against meningococcus (serogroups B, MenB; or ACWY, MenACWY) are recommended for patients at high risk of developing IMD. Our aim was to identify high-risk patients through a systematic search of medical codes and to evaluate vaccination coverage by high-risk group. Methods: An observational retrospective study was conducted in patients discharged at Reina Sofía University Hospital (Cordoba, Spain) from 1 January 2000, to 31 December 2023. Selection of high-risk patients was conducted through national administrative and clinical databases and vaccination coverage was determined through the Andalusian electronic vaccine database. Vaccine coverages of MenB and MenACWY were calculated within risk groups. Finally, bivariate analyses were conducted to assess the potential association between coverage, sex, and the year of admission. Results: A total of 2689 patients with 2710 high-risk conditions for IMD were identified from the databases searched. Of the 1755 requiring MenB vaccination, only 624 (35.6%) had received one dose and 558 (31.8%) two doses. Of the 2710 requiring MenACWY vaccination, only 784 (28.9%) had received one dose and 520 (19.2%) two doses. Patients with properdin-complement deficiencies showed the lowest vaccination rates (<10%). For the rest of the high-risk groups, vaccination coverages were significantly lower when the condition was diagnosed before the immunization guideline recommendations (p < 0.001). Conclusions: The identification of high-risk patients through databases using R-coded algorithms is both feasible and effective for identifying and catching-up patients for vaccination. The population at risk of IMD lacks adequate meningococcal vaccination coverage. Our methodology can serve to identify patients in other regions and for different vaccines.