Why coronavirus could be more fatal for men

Coronavirus which has earned the notoriety of being more dangerous for the elderly and the ailing, may also be discriminating when it comes to gender – in this case males, who seem to be dying more than females across the world, studies show.

A study of the fatality rates of several COVID-19-affected countries, conducted by different platforms, show that more men may be dying of the disease than women.

While an explanation for the trend is yet to be found, scientists have attributed it to a range of causes – from lifestyle habits, behavioural factors to genes, hormones and low immunity among men.

According to a report in The Guardian, the first trend of gender disparity in COVID-19-related fatalities was seen when a fatality rate of 2.8 per cent was seen in men compared to 1.7 per cent in women in China.

Similar trends were seen in France, Germany, Iran, Italy, South Korea and Spain, the report states.

While men accounted for 71 per cent of the deaths in Italy, the number of male casualties was double compared to women in Spain. In South Korea, even though more women tested positive than men, the death rate (54 per cent) among the latter was higher, reported CNN.

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Carlos III Health Institute (ISCIII) in Spain as part of a study analysed around 16,000 cases of coronavirus of which 566 were deaths. The study said while men were slightly vulnerable to contracting the disease (52 per cent) compared to women, they are definitely more vulnerable to dying from it. The number of men who died from the disease in the data sample were 376 compared to 190 women.

According to Spanish daily El Pais Fernando Simón, the director of Spain’s Health Ministry’s Coordination Center for Health Alerts, acknowledged the trend recently.

Dr Deborah Birx, the US White House’s response coordinator for coronavirus during a press briefing last week said that mortality in males seems to be twice in every age group of females in Italy and called it a “concerning trend.

“Just having the knowledge of that helps us in the United States so we can be very specific in talking to the American people about who to protect and how to protect them,” she told CNN.

Data check

The US-based daily which analysed publicly available data from 20 countries with the highest number of confirmed coronavirus cases till March 20 along with Global Health 50/50, an NGO found that men were 50 per cent more likely than women to succumb to COVID-19 than women.

The CNN report while making the stand, however, clarifies that the finding may not be final, because the data was not comprehensive as only six of the 20 countries had submitted sex-aggregated data (collected and analysed separately for males and females) for the study.

A report by BMJ Global Health states that a similar trend of risk to males, was witnessed during the SARS and MERS outbreaks.

“During previous epidemics of coronaviruses, male sex was associated with worse clinical outcomes due to severe acute respiratory syndrome (SARS) in Hong Kong, and a higher risk of dying from Middle East respiratory syndrome (MERS),” it says.

What’s causing the disparity?

While scientists are yet to pinpoint the cause for the disparity in fatality rate, the factors range from lifestyle habits, behavioural factor to genes, hormones and a reduced immunity among men.

A paper in The New England Journal of Medicine, looked at smoking as an important factor behind the higher mortality rate of men, drawing from the fact that 50 per cent men in China smoked compared to a mere 2 per cent of women.

The study found that smokers constituted 12 per cent of those with less severe symptoms, but also 26 per cent of those who were admitted to intensive care or died.

That apart, a cigarette is also one of the easiest mediums to contract the infection as it increases the touch of the hand to the lips – a big no in the WHO’s list of do and don’ts for coronavirus.

The theory, however, has not been accepted by many.

Behavioural factors such as washing hands is also being taken into consideration when it comes to contracting the disease. The Guardian quotes a study which says men are less likely to wash their hands or use a soap and even seek medical or public health advice, thereby making themselves vulnerable to diseases.

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Some attribute the disparity to women having a better immunity system than men, mostly because they can be bear children which means nurturing a foreign body inside them.

“There is actual research in animals that has shown there may be a biological basis for the sort of increasing susceptibility in the male gender and not only that but also an increased severity and response to the virus,” CNN quotes Dr Luis Ostrosky-Zeichner, infectious disease specialist at McGovern Medical School at UTHealth in Texas, as saying.

Research by Sabra Klein, a professor at Johns Hopkins Bloomberg School of Public Health has also shown that men have lower antiviral immune responses to infections including hepatitis C and HIV than women.

“Their immune system may not initiate an appropriate response when it initially sees the virus,” The Guardian quotes Klein as saying.

Scientists and researchers, however, say that the finding could have been conclusive if the countries whose data was used in the CNN- Global Health 50/50- study, had released sex aggregated data, which would have made it easier to study the trend.