COVID-19: why does it kill more men than women?

April 8, 2020
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Data from China, where the coronavirus pandemic began suggests men are at greater risk than women, although experts caution there could be factors other than gender, such as smoking habits, that could explain the link.

Prof Ian Hall, Professor of Molecular Medicine, University of Nottingham, said: “I am not convinced this completely explains the increased risk of severe disease in men, so it seems possible there may be some other as yet unidentified factor playing a role.”

Men are more likely than women to have heart disease, diabetes and chronic lung disease.

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Some have suggested genes and sex hormones might be involved too.

Are women more immune?

Prof Philip Goulder, an expert in immunology at University of Oxford, said: “It is becoming increasingly recognised that there are substantial differences in the immune system between males and females and that these have significant impact on outcome from a wide range of infectious diseases.

“The immune response throughout life to vaccines and infections is typically more aggressive and more effective in females compared to males.”

This could be down to women carrying two copies of the X chromosome, compared to the single X and a Y that men have.

A number of critical immune genes are located on the X chromosome.

Which people can get sick?

Most people with coronavirus will recover within about a week of getting symptoms and will not need medical care.

But some people will need to be treated in hospital.

Some people are at higher risk of complications.

This includes people over the age of 70, regardless of whether they have a medical condition or not, and people of any age with underlying health conditions, such as heart disease.

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There are more than 1.5 million people in the UK who are at the greatest risk of needing hospital treatment if they catch coronavirus.

This includes people with cancer who have been receiving chemotherapy, and they are being asked to stay at home all of the time to shield themselves from the virus.

Coronavirus also appears to disproportionately affect men in their 50s and 60s to a certain degree, although they are not singled out as a high risk group.

Why older men?

Scientists are not sure why this might be.

UK data from intensive care hospital wards shows the average patient who is critically ill is aged 60. Most are white men and many have other health conditions that could put them at increased risk, such as heart problems and obesity.

Of the 647 coronavirus-related deaths registered by the Office for National Statistics in England and Wales up to the week ending 27th March, 44 were aged 45-65 – around 7% of the total.

Death rates go up with age in both men and women, but men tend to outstrip women across the ages.

How can you protect yourself?

Stay as fit and healthy as you can by exercising and eating a balanced diet.

If you smoke, now is a good time to quit.

Men are more likely than women to:

  • smoke and smoke more cigarettes per day and smoke hand-rolled tobacco
  • eat too much salt
  • eat too much red and processed meat
  • eat too little fruit and too few vegetables
  • drink alcohol and drink at hazardous levels

Coronavirus spreads when an infected person coughs or sneezes small droplets – packed with the virus – into the air. These can be breathed in, or cause an infection if you touch a surface they have landed on, then your eyes, nose or mouth.

So, coughing and sneezing into tissues, not touching your face with unwashed hands, and avoiding close contact with infected people are important.



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