The Unsolved Mystery: Why Is Coronavirus More Lethal to Men?

RIO DE JANEIRO, BRAZIL – It is common knowledge that Covid-19 tends to affect more the elderly and those suffering from chronic diseases. However, there is one question that has puzzled scientists worldwide since the outbreak of the pandemic: why are men dying significantly more than women?

Initially, the ‘sexist’ trend of the novel coronavirus was observed in China, where the outbreak began. However, it also began to be noticed in countries such as France, Germany, Iran, Italy, South Korea, and Spain, according to a report by the BBC.

Although several studies have been conducted since the pandemic outbreak to unravel this mystery, the truth is that the scientific community is still not sure why this happens.

However, according to the BBC, most researchers believe that this may be due not to a single factor but rather the combination of several features that render women more immune to Covid-19 and that includes biology, lifestyle, and behavior.

Lifestyle issues

In China, preliminary studies have visibly shown that men were not only at greater risk of becoming infected but also of dying from the novel coronavirus.

A study involving 99 patients in a hospital in the city of Wuhan, where the pandemic broke out, found that two-thirds of the patients were men and more than half of those hospitalized had chronic pathologies such as heart disease or diabetes.

More recent data from the Chinese Center for Disease Control and Prevention, based on tens of thousands of cases, showed that 64 percent of deaths by Covid-19 were male.

The most likely cause would then be lifestyle. Around the world, men tend to drink and smoke more than women and are therefore more likely to develop lung diseases and heart disease, which weakens them if they become infected with Sars-coV-2.

And the truth is that the figures substantiate this theory: 48 percent of Chinese men over 15 smoke, compared to only two percent of women, according to the World Health Organization (WHO).

A study of 1,099 patients in China with Covid-19, published in the New England Journal of Medicine, showed that 26 percent of those who needed intensive care or died were smokers.

Additionally, the behavioral factor stood out. Research suggests that men wash their hands less than women, tend to use less soap, as well as not visiting the doctor as often and ignore alerts from health authorities.

In South Korea, for instance, although women account for 61 percent of confirmed cases, 54 percent of deaths are of men.

In Italy, seven out of ten deaths by Covid-19 are male patients, although 28 percent of men and 19 percent of women smoke.

And in Spain, the number of men killed is twice that of women.

Biological differences

On the other hand, studies have already shown that women generally have stronger immune systems than men and therefore circumvent infections more easily.

“We know more and more that there are substantial gender differences in the immune response to a range of infections and women generally react more powerfully and aggressively,” Philip Goulder, professor of immunology at Oxford University in the UK, told the BBC.

According to a recent study published in the scientific journal Human Genomics, the X chromosome contains a large number of immunity-related genes and, as women have two (men only have one), their bodies are better equipped to fight diseases.

Research has also found that estrogen, the sex hormone much more prevalent in women, protected females from mice infected with the SARS virus (Severe Acute Respiratory Syndrome), caused by another type of coronavirus and responsible for an outbreak in 2003.

However, despite increasing evidence, scientists agree that further data is needed to determine why men die more than women with Covid-19.

Recently, Global Health 50/50, a research institute linked to College London University in the United Kingdom, analyzed public data available from 20 countries with the highest number of confirmed cases of coronavirus as of March 20th.

Of these 20 countries, only six had data by gender for both confirmed cases and deaths – China, France, Germany, Italy, Iran, and South Korea. Another seven had data only for the number of confirmed cases.

“When we look at the data from these countries, the mortality rate of men from Covid-19 can exceed that of women by as much as ten to 90 percent,” Sarah Hawkes, professor of global public health at University College London (UCL) in the United Kingdom, reports to CNN.

Experts believe that if more countries had more in-depth information by gender, governments could use that data to develop public policies to fight the novel coronavirus.