Men are not only more likely to have more severe cases of Covid-19, but preliminary findings from a small study suggest that they are also more than twice as likely to die from the respiratory disease.

In the first examination of sex differences in response to SARS-CoV-2 infection, researchers determined that sex was shown to be a risk factor independent of age and susceptibility. Though men and women are equally as likely to contract SARS-CoV-2, the novel coronavirus responsible for Covid-19, men are significantly more likely to suffer severe effects and die as a result of infection, according to findings published in Frontiers in Public Health.

“Early in January, we noticed that the number of men dying from Covid-19 appeared to be higher than the number of women,” said  Dr Jin-Kui Yang, a physician at Beijing Tongren Hospital in China, in a statement. “This raised a question: are men more susceptible to getting or dying from COVID-19? We found that no-one had measured gender [sex] differences in Covid-19 patients, and so began investigating.”

Researchers turned to two datasets containing information on patients diagnosed with Covid-19, including 43 case series of people treated directly by doctors as well as more than 1,000 additional patient files. These were then compared with data on more than 500 patients diagnosed with Severe Acute Respiratory Syndrome (SARS) in the 2003 outbreak, due to the known behavior of both the SARS and Covid-19 viruses to attach to ACE2 proteins when invading the human cells.

In the largest dataset, men made up more than 70 percent of patients who died from the disease – an almost 2.5 increased likelihood compared with the death rate of age. Regardless of age or underlying conditions, being a male increases the risk of severe disease. This trend was also seen in SARS patients, an interesting discovery given that the ACE2 protein is presented in higher levels in men, as well as patients with cardiovascular disease and diabetes.

The authors caution that further research is needed to confirm the findings, but add that it is among the first preliminary indications that sex may play a role in risk factors. Identifying such factors can provide greater protection against and more informed treatment of those most at-risk, as well as presents the potential to provide additional necessary care for older men or those with underlying conditions.

“We recommend that additional supportive care and prompt access to the intensive care unit may be necessary for older male patients,” said Yang.

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