Early reports show that around twice as many men have died from COVID-19 than women. But why is that? At present, we are not sure. Some possible explanations are variations between the immune systems of men and women and higher rates of illness such as heart disease in men.

Unfortunately, not every country is collecting data on COVID-19 separately for men and women. That makes it harder to investigate whether there is a real difference in what happens to men and women. Additionally, with limited availability of testing, particularly in the community, it is not possible to know whether the difference in death rates is because a greater number of men than women acquire COVID-19 or because they are more likely to develop serious complications.

However, research from previous coronavirus outbreaks, such as SARS in 2002, has similarly shown that men seemed more likely to be hard hit by the infection. More research would help us understand why that is.

 

Where did the story come from?

Reports from around the world began to emerge in mid-March to suggest that men were more likely to get seriously ill and die if they were infected with the coronavirus.

The BBC Future website reported in mid-April on current theories about why men and women might be affected differently.

What is the basis for the claim?

The most up-to-date record of global COVID-19 cases and deaths suggests that men appear to be about 50% more likely to die from the virus than women. Of 34 countries reporting data on the ratio of COVID-19 deaths among men compared with women, all but 2 reported a higher ratio of deaths for men. This ranged from only 1.1 to 1 for Iran, to 3 to 1 in the Dominican Republic. Data for England and Wales as of the end of April 2020 shows that among the 19,000 COVID-19 deaths, 60% were in men or boys, and 40% among women or girls.

In a BMJ blog post about the figures, researchers said: “There are several potential explanations, not least is the possibility that the data may be skewed.”

However, as the BMJ authors suggest, there could be two other possible explanations. There could be differences between men and women in the immune system response to infection. Previous research found that women’s bodies mounted a stronger immune response to viral infection than men.  However, this might not provide the whole explanation, given that a heightened immune response has been associated with a greater risk of morbidity in COVID.

Another possible explanation is the difference between genders in lifestyle risk factors and health conditions that are associated with a greater risk of complications of COVID-19. For example, rates of smoking, cardiovascular disease, high blood pressure and COPD tend to be more common in men than women.

 

What do trusted sources say?

Neither the World Health Organisation nor the NHS website has any information about whether COVID-19 affects men and women differently.

The Global Health 50/50 organisation, which is collecting information about COVID-19 and gender, says: “At this point in the pandemic, we are unable to provide a clear answer to the question of the extent to which sex and gender are influencing the health outcomes of people diagnosed with COVID-19. However, experience and evidence thus far tell us that both sex and gender are important drivers of risk and response to infection and disease.”

Analysis by EIU Healthcare, supported by Reckitt Benckiser

 

Citation

  1. Purdie A et al. Sex, gender and COVID-19: Disaggregated data and health disparities. BMJ Global Health blogs https://blogs.bmj.com/bmjgh/2020/03/24/sex-gender-and-covid-19-disaggregated-data-and-health-disparities/ (Accessed 5 May 2020)

Reading list

  1. Global Health 50/50 COVID-19 sex-disaggregated data tracker. Available at http://globalhealth5050.org/covid19/ (Accessed 5 May 2020)