Coronavirus death: why does the virus kill men more than women?

Global death toll from New coronavirus There is increasing evidence that viruses cause more serious illness and death in men than women. In New York State For example, as of April 9, more than 60% of the more than 6,200 deaths are male.

From the beginning of the first coronavirus outbreak in China, men have become more severe than women. And this pattern appears to be largely repeated, even if it varies slightly from country to country.

Researchers are not completely sure why this is so. But there are already some interesting clues.

Are men more likely to smoke? Is medical treatment likely to be delayed? Or is there an answer between our body’s genes and sex hormones, which sets a high-risk course when men encounter the virus?

Professor Marcia Stefanic of Stanford University School of Medicine Told the Wall Street Journal“There are huge gender differences in the immune system, and this pandemic reveals them.” But she said, “What is biology, what are our social norms and sexual behavior, what happens. Confuses the ability to understand what you are doing. ”

Finding the answer will help develop more effective treatment protocols and preventive measures, and will lead to vaccine success.

Biopower of play

One of the important parts of the context of these questions is that, in general, there are various important biological differences in the way men and women fight infections. For example, women tend to have a stronger immune response. Researcher thinks This is partly because most women have two X chromosomes, which contain most genes related to the immune system (for genes that have two X chromosomes instead of one, There is also a diversity of immune responses). However, this extra immune function seems to increase women’s risk of autoimmune diseases such as rheumatoid arthritis and Crohn’s disease.

Hormones may also help provide women with more effective defenses. Some important immune cells have estrogen receptors and estrogen supplements Is shown To enhance the general immune response of mice.

2017 survey Immunology Journal Especially examined gender differences with coronavirus that causes SARS (it causes SARS) Seems to have killed During the 2003 outbreak, there were more men than women). In that study, researchers found that male mice were more susceptible to the virus. However, when estrogen prevented normal functioning in female mice, females became ill at a higher rate.

Women are also generally more likely to launch an early attack on the infection and may save the body so that the body does not have to use all of the fight against the virus. This is an event that can spur inflammation and often cause more damage to major organs.

These gender patterns are not common in infectious diseases. And data from other viruses, including influenza, can sometimes be distorted in other directions, More women have died than men. There is still much to be learned about the new coronavirus, and no studies have so far specifically examined these biological factors. It is not yet known how these biological differences are demonstrated in Covid-19. But they are definitely a possibility.

Behavioral factors may also be involved

There are also clues that different behaviors may increase men’s risk of serious Covid-19. What we have at this point is not a confirmation, but a possible risk, as epidemiologists can be a difficult (and time-consuming) attempt to elucidate the risk factors of behavior mutually. It is important to remember that this is a correlation that suggests.

One factor may be smoking prevalence. Review of existing studies As of March 17, he concluded that “smoking is most likely associated with negative progression and adverse consequences of Covid-19.” There are several reasons for this. who Note. One is that smokers are more likely to have lung disease. Established risk factors Severe infection. Second, smoking increases the likelihood of touching the mouth and face, which can make it easier for the virus to enter.

Smoking is more common in men than in women. by 2017 analysis Epidemiology and Community Health Journal54% of Chinese adult men smoked cigarettes, compared to only 2.6% of Chinese women. of World Bank Report As of 2016, about 41% of Korean men smoked about 6% of women. (Spain It also shows the same general trends as the United States, but with less gender than China and South Korea.)

Research on all of these is so new that it will take some time before we can clearly understand what role smoking can play.

Other widespread social and cultural shifts between gender, which are certainly not universal, can exacerbate this trend. For example, in the United States, various studies have identified men Reduce the frequency of washing your hands And Less likely to seek care Early in the disease. Ah March 24 Voting Reports from Reuters show that men are more seriously warned about coronaviruses than women.

Gender differences are not completely consistent

In this pandemic, the information reported worldwide is very different. And with the continued lack of testing, Underreported death, We still do not yet have a complete picture of how sex is being developed as a risk factor for illness, and how it varies from country to country. (Some governments, including the United States, do not even report cases by gender.) However, despite ambiguous details, the pattern is stable.

Analyzing data Approximately 2,000 patients during a December-February outbreak in China showed that about 60% of patients were male. And Chinese Center for Disease Control Male mortality is reported at 2.8% and female mortality at 1.7%.

In South Korea, men are much less likely to be confirmed to actually have Covid-19 Papers on March 31 Clinical infection. There, only 38 percent of the patients were male. However, the analysis showed that men were about twice as likely to die from the disease (1.19% of men versus 0.52% of women).

In Spain, men and women make up approximately the same number of Covid-19 cases. State Ministry of Health reported April 3. However, men were more than twice as likely to get involved in the ICU and were more likely to die (accounting for almost two-thirds of deaths).

April 6 Study of Lombardy’s blockbustersWe found that 82% of patients admitted to Italy, ICU, were male. And Italy as a wholeAbout 70 percent of the people who die of the coronavirus were men.

At present, the US CDC has not published a gender-specific breakdown of coronavirus cases (not prominently showing this data on other infectious diseases such as influenza). This is an additional blow to those who are trying to understand this rapidly spreading disease, as the United States has the most cases to date.

However, some U.S. states publish gender breakdowns. Ah Washington Post Report Of the 13 states reporting large details with large outbreaks, men were found to account for more deaths. As an emergency department nurse Told the post“In general, I have seen more male patients, and when they come in, they are getting worse.” (Recent US data also shows About patterns of racial differences. )

How understanding gender can help save our lives

Learning more about how the virus affects men and women can help determine the most effective treatment for individual patients. For example, it may point to a more targeted public health message to men who are likely to delay seeking another or previous intervention or treatment for men.

A better understanding of the nuances of male and female immune responses to the virus may also be important for developing good vaccines. There is Well documented differences Women tend to be better protected after vaccination in the effectiveness of the vaccine between men and women. It is therefore particularly important to ensure gender considerations when designing and analyzing vaccine trials— In both animal and human experiments.

Everyone is at risk—and everyone can help improve odds

Male mortality seems to be slightly higher than women, but everyone is at risk—Even young.

There are also some factors that may put some women at greater risk. For example, in the United States, 76% of health care workers are women. According to the US Census Bureau,. In other words, they are at the forefront of this pandemic and routinely contact people who may be infected.

Further digging into the data reveals other emerging trends in subpopulations. For example, April 2 report from the Italian governmentAbove 90, women were more likely to die of Covid-19 than men. Also, although the overall number is small, it appears that women with certain risk factors (heart failure, hypertension, dementia, etc.) are more likely to die from Covid-19 than men with those conditions.

All of this data reveals that there is still a lot to learn. Why some cases of Covid-19 end with respiratory failure or deathOr serious illness, and some are not-regardless of the gender of the person. And we all have a responsibility to get the virus and reduce the chance of spreading it to others. It is still important that everyone plays their part (wash hands, Maintain Avoid crowdsEtc.) to prevent the spread of the virus.

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