COVID-19 mortality: Are men more vulnerable than women?

More men than women die from SARS-CoV-2 infection, although it remains uncertain whether this difference is driven by biological dissimilarities between the sexes, or disparities in behavioural habits or in rates of comorbidities, according to a study.

Researchers conducted a systematic review and meta-analysis of 48 studies evaluating susceptibility to the SARS-CoV-2 infection and the concomitant risk of death. All the included studies presented data by sex, either for prevalence of positive tests, or hospitalization or deaths. There was neither study evaluation nor quantification synthesis due to the large heterogeneity among the studies.

Pooled data showed that worldwide, the proportion of men and women who tested positive for the infection was comparable. However, hospitalization rates and number of ICU admissions were higher among men than women in all countries which reported them. Of note, almost three-fourths (73 percent) of all ICU admissions throughout Europe were for men.

Reports from most early publications from China reported that compared with women, men were three times more likely to present prolonged SARS-CoV-2 RNA shedding, had twice the risk of developing kidney disease, as well as more frequently presented with refractory pneumonia and metabolic associated fatty liver disease (MAFLD). Likewise, in the Seattle and New York areas more men were admitted to the ICU.

In terms of mortality, while reported death rates varied tremendously between countries, almost all of the data that broke numbers down by gender revealed a greater proportion of deaths among male than female COVID-19 patients. This was true even in countries where fewer male cases were reported.

In light of the findings, the researchers called for the reporting of data by age, gender, and comorbidities, as this may have implications for vaccination strategies, the choice of treatments, and future consequences for long-term health issues concerning gender equality.