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Sex Differences in Case Fatality Rate of COVID-19: Insights From a Multinational Registry

Mohamad Alkhouli1, Aravinda Nanjundappa2, Frank Annie3

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.

Mayo Clinic Proceedings
|August 6, 2020
PubMed

Insights

Men with coronavirus disease 2019 (COVID-19) experienced significantly higher mortality rates compared to women. This increased risk in males persisted even after accounting for comorbidities, highlighting a sex-based disparity in COVID-19 outcomes.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Sex Differences in Health

Background:

  • Male sex has been anecdotally linked to increased mortality from coronavirus disease 2019 (COVID-19).
  • Understanding the relationship between sex and COVID-19 outcomes is crucial for public health strategies.

Purpose of the Study:

  • To investigate the association between male sex and COVID-19 mortality.
  • To determine if this association is dependent on patient age.

Main Methods:

  • A multinational database (COVID-19 Research Network via TriNetX) was queried for patients with confirmed COVID-19 infection.
  • All-cause mortality was the primary endpoint, analyzed before and after propensity score matching (PSM).
  • Kaplan-Meier survival analysis was employed to compare survival probabilities between sexes.

Main Results:

  • A total of 14,712 patients were analyzed; men had higher all-cause mortality rates than women both before (8.8% vs 4.3%) and after PSM (8.13% vs 4.60%).
  • Kaplan-Meier analysis revealed significantly lower cumulative survival probability in men (73-74%) compared to women (86%).
  • The higher mortality in men was not fully explained by their greater prevalence of comorbidities like hypertension and diabetes.

Conclusions:

  • Men with COVID-19 infection exhibit significantly higher mortality rates compared to women.
  • The observed sex disparity in COVID-19 mortality is not solely attributable to differences in comorbidity prevalence.
Abstract

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