COVID-19 gender susceptibility and outcomes: A systematic review

• Published in: PloS one Vol. 15; no. 11; p. e0241827
• Main Authors: Lakbar, Ines, Luque-Paz, David, Mege, Jean-Louis, Einav, Sharon, Leone, Marc
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03.11.2020; Public Library of Science (PLoS)
• Subjects: Adolescent sexuality; Betacoronavirus - isolation & purification; Biology and Life Sciences; Coronavirus Infections - diagnosis; Coronavirus Infections - mortality; Coronavirus Infections - pathology; Coronavirus Infections - virology; Coronaviruses; COVID-19; Demographic aspects; Disease Susceptibility; Epidemiology; Female; Health aspects; Hospitalization - statistics & numerical data; Humans; Infectivity; Influenza; Life Sciences; Literature reviews; Male; Medical research; Medicine and Health Sciences; Men; Middle East respiratory syndrome; Mortality; Observational studies; Odds Ratio; Pandemics; People and Places; Pneumonia, Viral - diagnosis; Pneumonia, Viral - mortality; Pneumonia, Viral - pathology; Pneumonia, Viral - virology; Public health; Research and Analysis Methods; Risk factors; SARS-CoV-2; Sepsis; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Sex differences; Sex differences (Biology); Sex Factors; Systematic review; Viral diseases; Women; Womens health; China; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241827

Epidemiological differences between men and women have been reported with regards to sepsis, influenza and severe coronavirus infections including SARS-CoV and MERS-CoV. To systematically review the literature relating to men versus women on SARS-CoV-2 in order to seek differences in disease characteristics (e.g. infectivity, severity) and outcomes (e.g. mortality). We searched 3 electronic databases up or observational studies reporting differences between men and women in the SARS-CoV-2 disease characteristics stated. We identified and included 47 studies, reporting data for 21,454 patients mainly from China. The unadjusted mortality rates of men were higher than those of women, with a mortality OR 0.51 [0.42, 0.61] (p<0.001) for women. The proportion of men presenting with severe disease and admitted to the intensive care unit (ICU) was also higher than that of women (OR 0.75 [0.60-0.93] p<0.001 and OR 0.45 [0.40-0.52] p<0.001 respectively). Adjusted analyses could not be conducted due to lack of data. COVID-19 may be associated with worse outcomes in males than in females. However, until more detailed data are provided in further studies enabling adjusted analysis, this remains an unproven assumption.