26/03/2020, 9h08, Photo: Reproduction.
Smoking, drinking, poor health in general: researchers say these are some of the factors that may explain why more men appear to be dying from the new coronavirus than women.
In Italy, men represent about 60% of positive diagnoses for COVID-19 and more than 70% of those who died, according to the local Institute of Health. In South Korea, where the proportion of women who tested positive for the virus is greater than that of men, about 54% of fatal cases are men.
In collaboration with Global Health 50/50, a research institute that analyzes gender inequality in global health, analyzing the data available from 20 countries with the largest number of confirmed cases of COVID-19 by 20 March.
Of those 20 countries, only six provided case and death data broken down by gender: China, France, Germany, Iran, Italy and South Korea. Another seven provided only confirmed case data. In the remaining nations, it was not possible to find the data with this filter. This research has been submitted for publication and has not yet been peer reviewed.
The data are not complete in all cases. For example, China’s figures only cover the period until the end of February, before community broadcasting in the country was zeroed out. There is also no reliable data on the proportion of tests applied to men and women in any country. In addition, there are undoubtedly cases of infections that have not entered the compilations of each nation.
However, in the countries where we have the numbers – which correspond to almost a quarter of the world population – we find that men are 50% more likely than women to die after being diagnosed with COVID-19.
Although incomplete, the results highlight what experts have been warning for a while, that this difference is due not only to biology, but also to specific behaviors of each gender.
Behavioral differences and pre-existing diseases
“When we look at the data, we see that in each country with data filtered by gender, there is a probability that ranges from 10% to 90% of higher mortality in men than women”, analyzes Sarah Hawkes, professor of global public health at the University from London and co-director of Global Health 50/50.
Historically, coronaviruses like SARS and MERS have affected more men, according to Luis Ostrosky-Zeichner, an infectious disease specialist at the University of Texas Health Sciences. Men were more affected by SARS in Hong Kong and were more at risk of dying from MERS in studies conducted in Saudi Arabia and South Korea.
From an evolutionary point of view, some research suggests that women have better immunity to viral infections than men because they have adapted to carry a foreign object inside their bodies – their children.
“It may also have to do with hormonal changes,” said Ostrosky-Zeichner. “There is research in animals that shows that there is a biological basis for this greater susceptibility in men.”
Initial data from people who were severely affected by COVID-19 show that they mostly had pre-existing chronic illnesses, such as hypertension, heart and lung problems, according to Global Health 50/50. In the six countries analyzed – and worldwide – these conditions tend to be more common in men, possibly due to riskier lifestyles.
“If COVID-19 is following the same patterns that we have seen in other diseases, what we do know is that men tend to be exposed to more risks and to have more behaviors that can compromise health in the long run,” said Hawkes.
“So in most countries, for example, what we see is that men smoke and drink more than women.”
Smoking is a clear example of the behavioral differences between men and women. China has the largest smoking population in the world, with about 316 million smokers. Approximately 50% of Chinese men smoke – but less than 3% of women do the same, according to the local Disease Control and Prevention Center.
In Italy, 7 million men smoke, against 4.5 million women, according to data from the National Institute of Health in 2020. The agency declared that, upon admission to the hospital, “one third of COVID-19 patients who were smokers had worse condition than non-smokers “.
Among smokers, the risk of requiring admission to the ICU and mechanical ventilation is more than double, “says the agency.
Other studies show that Italian men also have higher rates of hypertension than women of the same age. Chinese men also have higher rates of high blood pressure and type 2 diabetes.
All of these factors contribute to possible complications if they acquire the new virus, say the researchers.
However, the lack of gender-filtered data on coronavirus deaths is a missed opportunity for governments to implement health guidelines that focus on populations that are actually most vulnerable to the virus.
“What this pandemic reveals is a classic case of not using data to support decision-making,” says Kent Buse, co-founder of Global Health 50/50 and director of Unaids (UN body for combating HIV / AIDS) .
Arthur Caplan, a bioethicist at New York University, agrees. “All data that establish risk and the ability to recover are crucial during a pandemic.” “The data must be collected and disseminated quickly”.
Until these data are published, they cannot be analyzed by experts, such as Global Health 50/50, to find out why men are dying more from COVID-19 than women.
Source: CNN Brasil