COVID-19: Why do more men than women die from the virus?

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While British Columbia women are slightly more likely to test positive for the new coronavirus that causes COVID-19 – about 53 percent – they are much more likely to survive.

People admitted to intensive care units with symptoms of COVID-19 are more likely to have existing health problems such as heart disease, cancer or respiratory illnesses. They are also mostly men.

“Somewhere around 60, 65, 70% of critical care admissions are men,” said Dr. Bonnie Henry, provincial health worker for British Columbia.

Men 70 and older are also twice as likely to die from the virus as women the same age, a statistic that is echoed worldwide.

No one really knows why.

While British Columbia women are slightly more likely to test positive for the new coronavirus that causes COVID-19 – at around 53% – they are much more likely to survive, according to the latest British surveillance report. -British. Center for Disease Control.

“The whole question of why men are more likely to have a more serious illness than women is an issue around the world,” said Henry. “According to certain theories, our immune systems are different, men and women. “

The explanations at this point are mainly speculation.

Women have a more adaptable immune system, which allows them to manage children without triggering immune responses against the fetus, said Henry. Men’s immune responses are more aggressive against viruses when they invade the body.

But a Chinese study published in March without peer review found that levels of anti-COVID-19 antibodies were considerably higher in women than in men in the most severe cases.

It is also possible that a higher proportion of men in the most vulnerable age groups suffer from diseases and “genetic factors that we do not yet know,” said Henry.

Just as important to consider factors such as immigration status, race and wealth when looking for the roots of different health outcomes, said Julia Smith, a SFU researcher who examines the dynamics sex and gender of the COVID-19 epidemic.

Although Canada does not collect such detailed data, jurisdictions that have found that poverty and race may have an influence.

“I am disappointed that we do not collect data on race and ethnicity and gender,” she said. “It is really important to document who has higher infection rates, higher rates of ICU admissions and higher mortality. “

In the United States, African-Americans perform worse in some places, she said. “We don’t know if this is happening in Canada because we don’t have this data.”

“Sex and gender interact to influence everyone’s health outcomes,” according to an article in the British Medical Journal Global Health published in late March.

Past coronavirus outbreaks have shown a similar trend, note the authors.

Being male was also associated with poorer clinical outcomes in Hong Kong during the 2002-03 SARS outbreak. Men were also more at risk of dying from Middle East respiratory syndrome (MERS).

In the first data from Italy, Germany and China, men accounted for between 62% and 71% of deaths from COVID-19, which was disproportionately high compared to the number of confirmed infections.

The authors point out that the burden of existing health conditions is higher for men than for women and that men are more prone to risky behaviors, smoking tobacco and drinking alcohol. In Canada, however, women are more likely to smoke than men.

The global data set is unfortunately incomplete as many countries have not published a gender breakdown in their statistics.

Infectious Disease Specialist Dr. Srinivas Murthy cautioned against comparisons with SARS and MERS because the data sets are much smaller and it is possible that more men may have been exposed to these viruses than the women.

“Whether there are differences related to hormones or how something is expressed on the X chromosome compared to the Y chromosome, it is not clear,” he said. “There is a lot of biology under study to see if there are specific characteristics of being a man that contribute to a worse outcome. “

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