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COVID-19 affects people differently, in terms of infection with the virus SARS-CoV-2 and mortality rates. In this Special Feature, we focus on some of the sex differences that characterize this pandemic. Share on Pinterest The data that are available so far indicate that there are significant differences between how the sexes respond to the new coronavirus.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on the COVID-19 pandemic.Was this helpful?

There are many ways in which the pandemic itself affects peoples day-to-day lives, and gender understood as the ensemble of social expectations, norms, and roles we associate with being a man, woman, trans- or nonbinary person plays a massive part.

On a societal level, COVID-19 has affected cis- and transwomen, for example, differently to how it has cismen, transmen, and nonbinary people. Reproductive rights, decision making around the pandemic, and domestic violence are just some key areas where the pandemic has negatively impacted women.

However, sex differences understood as the biological characteristics we associate with the sex that one is assigned at birth also play an undeniable role in an epidemic or pandemic.

While sex and gender are, arguably, inextricably linked in healthcare, as in every other area of our lives, in this Special Feature, we will focus primarily on the infection rates of SARS-CoV-2 and the mortality rates that COVID-19 causes, broken down by sex.

In specialized literature, these effects fall under the umbrella term of primary effects of the pandemic, while the secondary impact of the pandemic has deeper social and political implications.

Throughout this feature, we use the binary terms man and woman to accurately reflect the studies and the data they use. Sex-disaggregated data lacking

Before delving deeper into the subject of sex differences in COVID-19, it is worth noting that the picture is bound to be incomplete, as not all countries have released their sex-disaggregated data.

A report appearing on the blog of the journal BMJ Global Health on March 24, 2020, reviewed data from 20 countries that had the highest number of confirmed cases of COVID-19 at the time.

Of these 20 countries, Belgium, Malaysia, Netherlands, Portugal, Spain, United Kingdom, and the United States of America did not provide data that was disaggregated, or broken down, by sex.

At the time, the authors of the BMJ report appealed to these countries and others to provide sex specific data.

Anna Purdie, from the University College London, United Kingdom, and her colleagues, noted: We applaud the decision by the Italian government to publish data that are fully sex- and age-disaggregated. Other countries [] are still not publishing national data in this way. We understand but regret this oversight.
At a minimum, we urgently call on countries to publicly report the numbers of diagnosed infections and deaths by sex. Ideally, countries would also disaggregate their data on testing by sex.

Anna Purdie et al.

Since then, countries that include Belgium, the Netherlands, Portugal, and Spain have made their data available.

The U.K. have made only a part of the sex-disaggregated data available for England and Wales, without covering Scotland and Northern Ireland while Malaysia and the U.S. have not made their sex-disaggregated data available at all.

At the time of writing this article, the U.S. still have not released their sex-disaggregated data despite the country having the highest number of COVID-19 cases in the world.

For more research-backed information and resources for mens health, please visit our dedicated hub.Was this helpful? Men more than twice as likely to die

Global Health 5050, an organization that promotes gender equality in healthcare, has rounded up the total and partial data that is available from the countries with the highest numbers of confirmed COVID-19 cases.

According to their data gathering, the highest ratio of male to female deaths, as a result of COVID-19, is in Denmark and Greece: 2.1 to 1.

In these countries, men are more than twice as likely to die from COVID-19 as women. In Denmark, 5.7% of the total number of cases confirmed among men have resulted in death, whereas 2.7% of women with confirmed COVID-19 have died.

In the Republic of Ireland, the male to female mortality ratio is 2 to 1, while Italy and Switzerland have a 1.9 to 1 ratio each.

The greatest parity between the genders from countries that have submitted a full set of data are Iran, with 1.1 to 1, and Norway, with 1.2 to 1.

In Iran, 5.4% of the women patients have died, compared with 5.9% of the men. In Norway, these numbers stand at 1.3% and 1.1%, respectively.

China has a ratio of 1.7, with 2.8% of women having died, compared with 4.7% of men.
Infection rates in womenand men

A side-by-side comparison of infection rates between the sexes does not explain the higher death rates in men, nor is there enough data available to draw a conclusion about infection rates broken down by sexes.

However, it is worth noting that in Denmark, where men are more than twice as likely to die of COVID-19 as women, the proportion of women who contracted the virus was 54%, while that of men was 46%.

By contrast, in Iran, where the ratio of deaths between men and women is less different (1.1 to 1), just 43% of cases are female compared with 57% cases in men.

Until we know the proportion of people from each sex that healthcare professionals are testing, it will be difficult to fully interpret these figures.

What we do know so far is that, overall, nine of the 18 countries that have provided complete sex-disaggregated data have more COVID-19 cases among women than they do among men. Six of the 18 countries have more cases among men than they do among women.

Norway, Sweden, and Germany have a 5050% case ratio.

Other countries where more women have developed COVID-19 include:
Switzerland (53% of women to 47% of men)Spain (51% to 49%)The Netherlands (53% to 47%)Belgium (55% to 45%)South Korea (60% to 40%)Portugal (57% to 43%)Canada (52% to 48%)Republic of Ireland (52% to 45%)

Greece, Italy, Peru, China, and Australia all have a higher number of confirmed cases among men than women.Why are men more likely to die?

Part of the explanation for why the new coronavirus seems to cause more severe illness in men is down to biological sex differences.

Womens innate immune response plays a role. Experts agree that there are sex differences, such as sex chromosomes and sex hormones, that influence how a persons immunity responds to a pathogen.

As a result, women are in general able to mount a more vigorous immune response to infections [and] vaccinations. With previous coronaviruses, specifically, some studies in mice have suggested that the hormone estrogen may have a protective role.

For instance, in the study above, the authors note that in male mice there was an exuberant but ineffective cytokine response. Cytokines are responsible for tissue damage within the lungs and leakage from pulmonary blood vessels.

Estrogens suppress the escalation phase of the immune response that leads to increased cytokine release. The authors showed that female mice treated with an estrogen receptor antagonist died at close to the same rate as the male mice.

As some researchers have noted, lifestyle factors, such as smoking and alcohol consumption, which tend to occur more among men, may also explain the overall higher mortality rates among men.

Science has long linked such behaviors with conditions that we now know are likely to negatively influence the outcome of patients with COVID-19 cardiovascular disease, hypertension, and chronic lung conditions. Why women might be more at risk

On the other hand, the fact that societies have traditionally placed women in the role of caregivers a role which they continue to fulfill predominantly and the fact that the vast majority of healthcare workers are women cold place them at a higher risk of contracting the virus and might explain the higher infection rates in some countries.

An analysis of 104 countries by the World Health Organization (WHO) found that Women represent around 70% of the health workforce. In China, women make up more than 90% of healthcare workers in Hubei province.

These data emphasize the gendered nature of the health workforce and the risk that predominantly female health workers incur, write the authors of a report on the gendered impacts of the pandemic that appears in The Lancet.

Although we cannot yet draw definitive conclusions because sex-disaggregated data is not yet available from all the countries affected, The Lancet report looks at previous epidemics for clues.

During the 201416 west African outbreak of Ebola virus disease, the authors write, gendered norms meant that women were more likely to be infected by the virus, given their predominant roles as caregivers within families and as frontline healthcare workers.

The authors also call out for governments and health institutions to offer and analyze data on sex and gender differences in the pandemic.
Why sex-disaggregated data are urgent

The report in The Lancet reads, Recognising the extent to which disease outbreaks affect women and men differently is a fundamental step to understanding the primary and secondary effects of a health emergency on different individuals and communities, and for creating effective, equitable policies and interventions.

For instance, identifying the key difference that makes women more resilient to the infection could help create drugs that also strengthen mens immune response to the virus.

Devising policies and intervention strategies that consider the needs of women who work as frontline healthcare workers could help prevent the higher infection rates that we see among women.

Finally, men and women tend to react differently to potential vaccines and treatments, so having access to sex-disaggregated data is crucial for conducting safe clinical trials.

As Anna Purdie who also works for Global Health 5050 and her colleagues summarize in their article, Sex-disaggregated data are essential for understanding the distributions of risk, infection, and disease in the population, and the extent to which sex and gender affect clinical outcomes.
Understanding sex and gender in relation to global health should not be seen as an optional add-on but as a core component of ensuring effective and equitable national and global health systems that work for everyone. National governments and global health organizations must urgently face up to this reality.

Anna Purdie et al

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It’s MLB Home Run Derby Day! Predictions, live updates and takeaways

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It's MLB Home Run Derby Day! Predictions, live updates and takeaways

It’s 2025 MLB All-Star Home Run Derby day in Atlanta!

Some of the most dynamic home run hitters in baseball will be taking aim at the Truist Park stands on Monday (8 p.m. ET on ESPN) in one of the most anticipated events of the summer.

While the prospect of a back-to-back champion is out of the picture — 2024 winner Teoscar Hernandez is not a part of this year’s field — a number of exciting stars will be taking the field, including Atlanta’s own Matt Olson, who replaced Ronald Acuna Jr. just three days before the event. Will Olson make a run in front of his home crowd? Will Cal Raleigh show off the power that led to 38 home runs in the first half? Or will one of the younger participants take the title?

We have your one-stop shop for everything Derby related, from predictions to live updates once we get underway to analysis and takeaways at the night’s end.


MLB Home Run Derby field

Cal Raleigh, Seattle Mariners (38 home runs in 2025)
James Wood, Washington Nationals (24)
Junior Caminero, Tampa Bay Rays (23)
Byron Buxton, Minnesota Twins (21)
Brent Rooker, Athletics (20)
Matt Olson, Atlanta Braves (17)
Jazz Chisholm Jr., New York Yankees (17)
Oneil Cruz, Pittsburgh Pirates (16)


Live updates


Who is going to win the Derby and who will be the runner-up?

Jeff Passan: Raleigh. His swing is perfect for the Derby: He leads MLB this season in both pull percentage and fly ball percentage, so it’s not as if he needs to recalibrate it to succeed. He has also become a prolific hitter from the right side this season — 16 home runs in 102 at-bats — and his ability to switch between right- and left-handed pitching offers a potential advantage. No switch-hitter (or catcher for that matter) has won a Home Run Derby. The Big Dumper is primed to be the first, beating Buxton in the finals.

Alden Gonzalez: Cruz. He might be wildly inconsistent at this point in his career, but he is perfect for the Derby — young enough to possess the stamina required for a taxing event that could become exhausting in the Atlanta heat; left-handed, in a ballpark where the ball carries out better to right field; and, most importantly, capable of hitting balls at incomprehensible velocities. Raleigh will put on a good show from both sides of the plate but will come in second.

Buster Olney: Olson. He is effectively pinch-hitting for Acuna, and because he received word in the past 72 hours of his participation, he hasn’t had the practice rounds that the other competitors have been going through. But he’s the only person in this group who has done the Derby before, which means he has experienced the accelerated pace, adrenaline and push of the crowd.

His pitcher, Eddie Perez, knows something about performing in a full stadium in Atlanta. And, as Olson acknowledged in a conversation Sunday, the park generally favors left-handed hitters because of the larger distances that right-handed hitters must cover in left field.

Jesse Rogers: Olson. Home-field advantage will mean something this year as hitting in 90-plus degree heat and humidity will be an extra challenge in Atlanta. Olson understands that and can pace himself accordingly. Plus, he was a late addition. He has got nothing to lose. He’ll outlast the young bucks in the field. And I’m not putting Raleigh any lower than second — his first half screams that he’ll be in the finals against Olson.

Jorge Castillo: Wood. His mammoth power isn’t disputed — he can jack baseballs to all fields. But the slight defect in his power package is that he doesn’t hit the ball in the air nearly as often as a typical slugger. Wood ranks 126th out of 155 qualified hitters across the majors in fly ball percentage. And he still has swatted 24 home runs this season. So, in an event where he’s going to do everything he can to lift baseballs, hitting fly balls won’t be an issue, and Wood is going to show off that gigantic power en route to a victory over Cruz in the finals.


Who will hit the longest home run of the night — and how far?

Passan: Cruz hits the ball harder than anyone in baseball history. He’s the choice here, at 493 feet.

Gonzalez: If you exclude the Coors Field version, there have been just six Statcast-era Derby home runs that have traveled 497-plus feet. They were compiled by two men: Aaron Judge and Giancarlo Stanton. James Wood — all 6-foot-7, 234 pounds of him — will become the third.

Olney: James Wood has the easy Stanton- and Judge-type power, and he will clear the Chophouse with the longest homer. Let’s say 497 feet.

Rogers: Hopefully he doesn’t injure himself doing it, but Buxton will break out his massive strength and crush a ball at least 505 feet. I don’t see him advancing far in the event, but for one swing, he’ll own the night.

Castillo: Cruz hits baseballs hard and far. He’ll crush a few bombs, and one will reach an even 500 feet.


Who is the one slugger fans will know much better after the Derby?

Passan: Buxton capped his first half with a cycle on Saturday, and he’ll carry that into the Derby, where he will remind the world why he was baseball’s No. 1 prospect in 2015. Buxton’s talent has never been in question, just his health. And with his body feeling right, he has the opportunity to put on a show fans won’t soon forget.

Olney: Caminero isn’t a big name and wasn’t a high-end prospect like Wood was earlier in his career. Just 3½ years ago, Caminero was dealt to the Rays by the Cleveland Guardians in a relatively minor November trade for pitcher Tobias Myers. But since then, he has refined his ability to cover inside pitches and is blossoming this year into a player with ridiculous power. He won’t win the Derby, but he’ll open some eyes.


What’s the one moment we’ll all be talking about long after this Derby ends?

Gonzalez: The incredible distances and velocities that will be reached, particularly by Wood, Cruz, Caminero, Raleigh and Buxton. The hot, humid weather at Truist Park will only aid the mind-blowing power that will be on display Monday night.

Rogers: The exhaustion on the hitter’s faces, swinging for home run after home run in the heat and humidity of Hot-lanta!

Castillo: Cruz’s 500-foot blast and a bunch of other lasers he hits in the first two rounds before running out of gas in the finals.

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Report: Sternberg to sell Rays for $1.7 billion

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Report: Sternberg to sell Rays for .7 billion

Tampa Bay Rays owner Stu Sternberg has agreed in principle to a $1.7 billion deal to sell the franchise to a group led by a Florida-based developer Patrick Zalupski, according to a report from The Athletic.

The deal is reportedly expected to be closed as early as September and will keep the franchise in the area, with Zalupski, a homebuilder in Jacksonville, having a strong preference to land in Tampa rather than St. Petersburg.

Sternberg bought the Rays in 2004 for $200 million.

According to Zalupski’s online bio, he is the founder, president and CEO of Dream Finders Homes. The company was founded in December 2008 and closed on 27 homes in Jacksonville the following year. Now, with an expanded footprint to many parts of the United States, Dream Finders has closed on more than 31,100 homes since its founding.

He also is a member of the board of trustees at the University of Florida.

The new ownership group also reportedly includes Bill Cosgrove, the CEO of Union Home Mortgage, and Ken Babby, owner of the Akron RubberDucks and Jacksonville Jumbo Shrimp, both minor-league teams.

A year ago, Sternberg had a deal in place to build a new stadium in the Historic Gas Plant District, a reimagined recreational, retail and residential district in St. Petersburg to replace Tropicana Field.

However, after Hurricane Milton shredded the roof of the stadium last October, forcing the Rays into temporary quarters, Sternberg changed his tune, saying the team would have to bear excess costs that were not in the budget.

“After careful deliberation, we have concluded we cannot move forward with the new ballpark and development project at this moment,” Sternberg said in a statement in March. “A series of events beginning in October that no one could have anticipated led to this difficult decision.”

MLB commissioner Rob Manfred and some other owners began in March to privately push Sternberg to sell the franchise, The Athletic reported.

It is unclear what Zalupski’s group, if it ultimately goes through with the purchase and is approved by MLB owners, will do for a permanent stadium.

The Rays are playing at George M. Steinbrenner Field in Tampa, located at the site of the New York Yankees‘ spring training facility and home of their Single-A Tampa Tarpons.

Field Level Media contributed to this report.

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Ohtani hits leadoff for NL; Raleigh cleanup for AL

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Ohtani hits leadoff for NL; Raleigh cleanup for AL

ATLANTA — Shohei Ohtani will bat leadoff as the designated hitter for the National League in Tuesday night’s All-Star Game at Truist Park, and the Los Angeles Dodgers star will be followed in the batting order by left fielder Ronald Acuna Jr. of the host Atlanta Braves.

Arizona second baseman Ketel Marte will hit third in the batting order announced Monday by Dodgers manager Dave Roberts, followed by Los Angeles first baseman Freddie Freeman, San Diego Padres third baseman Manny Machado, Dodgers catcher Will Smith, Chicago Cubs right fielder Kyle Tucker, New York Mets shortstop Francisco Lindor and Cubs center fielder Pete Crow-Armstrong.

Pittsburgh Pirates right-hander Paul Skenes will start his second straight All-Star Game, Major League Baseball announced last week. Detroit Tigers left-hander Tarik Skubal will make his first All-Star start for the American League.

“I think when you’re talking about the game, where it’s at, these two guys … are guys that you can root for, are super talented, are going to be faces of this game for years to come,” Roberts said.

Detroit second baseman Gleyber Torres will lead off for the AL, followed by Tigers left fielder Riley Greene, New York Yankees right fielder Aaron Judge, Seattle Mariners catcher Cal Raleigh, Toronto Blue Jays first baseman Vladimir Guerrero Jr., Baltimore Orioles designated hitter Ryan O’Hearn, Tampa Bay Rays third baseman Junior Caminero, Tigers center fielder Javy Báez and Athletics shortstop Jacob Wilson.

Ohtani led off for the AL in the 2021 All-Star Game, when the two-way sensation also was the AL’s starting pitcher. He hit leadoff in 2022, then was the No. 2 hitter for the AL in 2023 and for the NL last year after leaving the Los Angeles Angels for the Dodgers.

Skenes and Skubal are Nos. 1-2 in average four-seam fastball velocity among those with 1,500 or more pitches this season, Skenes at 98.2 mph and Skubal at 97.6 mph, according to MLB Statcast.

A 23-year-old right-hander, Skenes is 4-8 despite a major league-best 2.01 ERA for the Pirates, who are last in the NL Central. The 2024 NL Rookie of the Year has 131 strikeouts and 30 walks in 131 innings.

Skubal, a 28-year-old left-hander, is the reigning AL Cy Young Award winner. He is 10-3 with a 2.23 ERA, striking out 153 and walking 16 in 121 innings.

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