Is Coronavirus More Fatal in Men Than Women?

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With more than 200,000 coronavirus cases worldwide and thousands of deaths, a striking pattern is appearing in the hardest-hit countries: more men are dying than women.

Nowhere is this trend more pronounced than in Italy. Men make up nearly 60 percent of people with confirmed cases of the virus and more than 70 percent of those who have died from Covid-19, according to the country’s main public health research agency.

On the other end of the spectrum is South Korea, where about 61 per cent of confirmed infections have been in women. Though far fewer patients have died, the majority of fatalities – 54 percent - were again in men.

As the pandemic escalates, epidemiologists and public health authorities are scrambling to understand who is most vulnerable and how to protect them. The data from countries such as Italy and South Korea show that the disease can take wildly different paths.

Exactly what makes a group vulnerable – and how to protect them – has experts “mystified,” said Carlos del Rio, chair of the department of global health at Emory University. “This difference in mortality is creating a lot of anxiety,” he added.

The outbreak of Covid-19 in Italy is the deadliest in the world. As of 17 March, more than 40,000 people there have been sickened with the virus, and 3,405 have died. That means that, based on these current and unavoidably incomplete figures, 8.2 percent of people infected in the country have died. That is more than double the global figure presented recently by the WHO.

Italy’s aging population is probably particularly susceptible to the disease, researchers say. With a median age of 46.5, according to the CIA World Factbook, it is the fifth oldest country in the world. And these elderly citizens are those who have become the sickest: people over the age of 70 represent more than 87 percent of deaths there.

Older people are typically hit harder with respiratory diseases, Mr del Rio said. They are more likely to get pneumonia – an infection that inflames the lungs and fills them with fluid or pus – and to have underlying health conditions that could make them vulnerable to the virus.

“With older people,” del Rio said, “sometimes it doesn’t take very much to push you over the edge.”

The gender disparity in illness and death is harder to explain. Even before the Covid-19 pandemic reached Italy, early reports out of China suggested men were especially at risk. A study of 99 patients at a hospital in Wuhan, where the virus originated, found that men made up two-thirds of patients, and half of all the people who were hospitalized had chronic conditions such as heart disease or diabetes. More recent figures from China’s Centre for Disease Control, based on tens of thousands of cases, showed a strong gender breakdown of deaths, which were 64 percent male.

But the figures in Italy have been even more staggering. Nearly 60 percent of diagnoses have been in men, according to Italy’s top health research agency, Istituto Superiore di Sanità. Across the first 1,697 coronavirus deaths, 71 percent – 1,197 – were in men. Just 29 percent, or 493, were in women.

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