Why is coronavirus killing more men than women?

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When scientists began examining the first data to come out of China, the epicenter of the coronavirus pandemic which has now swept the world, they noticed something striking: More men were dying than women.

Since then, data from various countries appears to confirm their initial findings. While women generally have a longer life expectancy than men, many have questioned how a virus could discriminate by gender, and what it might tell us about who is most vulnerable from COVID-19.

Here is what we know about how sex affects coronavirus – and what we still need to find out.

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The data

Collecting data about coronavirus is still a work in progress, meaning there is still a lot we don’t know about COVID-19.
Generally, however, most of the available data so far confirms that men have a higher fatality rate than women.

In a report by the Chinese Center for Disease and Prevention published February 11, which reviewed the then 44,000 cases in China, men were found to have a higher death rate: 2.8 percent compared to women’s 1.7 percent.

Since then, the virus has spread across the world, infecting countries and forcing them into collecting their own data as they fight against the global pandemic. Further studies all indicate that men have a higher death rate.

According to data collected by the Global 50/50 project accurate as of April 3, men made up 69 percent of the deaths from coronavirus in both Italy and Spain.

Dr. Maher Balkis, an associate staff physician, infectious diseases, at Cleveland Clinic Abu Dhabi, confirmed these findings. He pointed to preliminary data that suggested that 60 percent of COVID-19 cases globally were men, as well as research from China which indicates that men are 65 percent more likely to die from the virus.

“Data from around the world does seem to indicate that men are more susceptible to infection by the virus that causes COVID-19 than women. In addition, data shows that men are significantly more likely to become seriously ill and die from the disease,” explained Dr. Balkis.

However, the data is still preliminary and requires more samples.

Some countries, including the US, have not been presenting data by sex – making it difficult for scientists to build up a larger database. As with other features of coronavirus, scientists are still learning and need more concrete data to make stronger conclusions.

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The explanations

Several explanations have been put forward to explain the disparity in death rates.

Some look at difference in behavior between men and women.

“Lifestyle choices and behaviors play a part, with men less likely to seek medical help at the first signs of disease or to follow public heath advice,” said Dr. Balkis.

Men are also more likely to drink and smoke, which some researchers have tied to a higher chance of dying from COVID-19. Drinking and smoking also increase the chance of having preexisting illnesses which increase the death rate from the disease.

Studies have also shown that men are less likely to wash their hands, a key way of preventing infection.

Others consider sex-based differences in the immune system, the human body’s form of defense against illness.

“Women are less susceptible to infection and ten times more likely to develop an auto-immune disorder,” said Dr. Balkis.

“Both hormone balance and genetic factors have been linked to this disparity. Estrogen, which women have much more of than men, plays a role in increasing women’s antiviral response,” he explained.

“A significant number of genes that regulate immune response are encoded on the X chromosome, of which women have two compared to men’s one. Research into the difference between men and women’s immune systems is ongoing,” he added.

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