Epidemiology: Global analysis finds male patients are at higher risk of severe COVID-19

A global analysis of over three million cases of COVID-19, suggests that male patients with the disease are almost three times more likely to require admission to intensive care than female patients. The study, published in Nature Communications, also finds that male patients have a higher risk of death from COVID-19.

Evidence suggests that there is a bias towards increased disease severity from COVID-19 in male patients. However, this has not been validated in a large-scale analysis of global data.

In a meta-analysis of 92 reports from between 1 January 2020 and 1 June 2020 obtained from government websites and published literature, Kate Webb, Claire Deakin and colleagues investigated whether sex was a risk factor for SARS-CoV-2 infection, and mortality from COVID-19. In total, their analysis included 3,111,714 cases, where sex was recorded, from 46 countries and 44 states in the United States. The authors found that there was no difference in the proportion of male and female patients who were infected with SARS-CoV-2 in their sample. However, male patients were found to have increased odds (2.84 times higher) of being admitted to an intensive care unit as a result of COVID-19. The odds of death from COVID-19 were 1.39 times higher for male patients in their sample than females.

The authors suggest that differences in the immune responses of different sexes are likely to be a factor in the results they observed. However, other biological factors and sex-based co-morbidities may also have an influence. The authors argue that although further studies are needed, these data have important implications for the clinical management of COVID-19 and mitigation strategies.