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Abstract
Anecdotal evidence suggests that Coronavirus disease 2019 (COVID-19), caused by the coronavirus SARS-CoV-2, exhibits differences in morbidity and mortality between sexes. Here, we present a meta-analysis of 3,111,714 reported global cases to demonstrate that, whilst there is no difference in the proportion of males and females with confirmed COVID-19, male patients have almost three times the odds of requiring intensive treatment unit (ITU) admission (OR = 2.84; 95% CI = 2.06, 3.92) and higher odds of death (OR = 1.39; 95% CI = 1.31, 1.47) compared to females. With few exceptions, the sex bias observed in COVID-19 is a worldwide phenomenon. An appreciation of how sex is influencing COVID-19 outcomes will have important implications for clinical management and mitigation strategies for this disease.
Anecdotal reports suggest potential severity and outcome differences between sexes following infection by SARS-CoV-2. Here, the authors perform meta-analyses of more than 3 million cases collected from global public data to demonstrate that male patients with COVID-19 are 3 times more likely to require intensive care, and have ~40% higher death rate.
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1 Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, UK; Centre for Rheumatology Research, Division of Medicine, UCL, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201)
2 Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, UK (GRID:grid.83440.3b); Centre for Rheumatology Research, Division of Medicine, UCL, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201)
3 Centre for Rheumatology Research, Division of Medicine, UCL, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201)
4 Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, UK (GRID:grid.83440.3b); UCL Great Ormond Street Institute of Child Health, Infection, Immunity and Inflammation Research and Teaching Department, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201); NIHR Biomedical Research Centre at Great Ormond Street Hospital, London, UK (GRID:grid.451056.3) (ISNI:0000 0001 2116 3923)
5 Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, UK (GRID:grid.451056.3); Centre for Rheumatology Research, Division of Medicine, UCL, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201)
6 University of Cape Town, Department of Paediatric Rheumatology, School of Child and Adolescent Health, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa (GRID:grid.7836.a) (ISNI:0000 0004 1937 1151); Crick African Network, The Francis Crick Institute, London, UK (GRID:grid.451388.3) (ISNI:0000 0004 1795 1830)
7 Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, UK (GRID:grid.451388.3); UCL Great Ormond Street Institute of Child Health, Infection, Immunity and Inflammation Research and Teaching Department, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201); NIHR Biomedical Research Centre at Great Ormond Street Hospital, London, UK (GRID:grid.451056.3) (ISNI:0000 0001 2116 3923)