Connect with us

Published

on

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 Some information may be out of date.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

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

Continue Reading

Sports

Sankey asks NCAA to rescind betting rule change

Published

on

By

Sankey asks NCAA to rescind betting rule change

The SEC has asked the NCAA to rescind a pending rule change that will allow athletes and athletic department staff members to bet on professional sports beginning on Nov. 1, according to a copy of a memo obtained by ESPN.

SEC commissioner Greg Sankey sent a letter to NCAA president Charlie Baker on Oct. 25, stating that during an Oct. 13 conference meeting, “The message of our Presidents and Chancellors was clear and united: this policy change represents a major step in the wrong direction.”

Last week, the NCAA’s Division I cabinet approved a rule change to allow betting on professional sports, and Division II and III management councils also signed off on it, allowing it to go into effect on Saturday. NCAA athletes are still prohibited from betting on college sports and sharing information about college sports with bettors. Betting sites also aren’t allowed to advertise or sponsor NCAA championships.

“On behalf of our universities, I write to urge action by the NCAA Division I Board of Directors to rescind this change and reaffirm the Association’s commitment to maintaining strong national standards that keep collegiate participants separated from sports wagering activity at every level,” Sankey wrote. “If there are legal or practical concerns about the prior policy, those should be addressed through careful refinement — not through wholesale removal of the guardrails that have long supported the integrity of games and the well-being of those who participate.”

If the rule goes into effect, it would mark a shift in a long-held policy that had become difficult to enforce with an increase in legal sports betting in the United States. The NCAA has faced an uptick in alleged betting violations by players in recent years. In September, the NCAA announced that a Fresno State men’s basketball player had manipulated his own performance for gambling purposes and conspired with two other players in a prop betting scheme. The NCAA is investigating 13 additional players from six schools regarding potential gambling violations dealing with integrity issues.

On Oct. 22, when the NCAA announced the adoption of the new proposal, it stated that approving the rule change “is not an endorsement of sports betting, particularly for student-athletes.”

“Our action reflects alignment across divisions while maintaining the principles that guide college sports,” said Roberta Page, director of athletics at Slippery Rock and chair of the Division II Management Council, in the NCAA’s news release. “This change recognizes the realities of today’s sports environment without compromising our commitment to protecting the integrity of college competition or the well-being of student-athletes.”

Sankey wrote that the “integrity of competition is directly threatened when anyone with insider access becomes involved in gambling.” He also said the SEC is “equally concerned about the vulnerability of our student-athletes.”

“The SEC’s Presidents and Chancellors believe the NCAA should restore its prior policy-or a modified policy-communicating a prohibition on gambling by student-athletes and athletics staff, regardless of the divisional level of their sport,” Sankey wrote. “While developing and enacting campus or conference-level policy may be considered, the NCAA’s policy has long stood as an expression of our collective integrity, and its removal sends the wrong signal at a time when the gambling industry is expanding its reach and influence.”

ESPN’s Pete Thamel contributed to this report.

Continue Reading

Sports

Kiffin trolls Venables over Ole-Miss-OU ‘hot take’

Published

on

By

Kiffin trolls Venables over Ole-Miss-OU 'hot take'

Lane Kiffin could not resist taking a shot at Brent Venables, sarcastically accusing the Oklahoma coach of a “hot take” in his evaluation of last weekend’s game against Ole Miss.

Kiffin and the seventh-ranked Rebels rallied for a 34-26 victory Saturday in Norman, Oklahoma, against Venables and the Sooners. Venables said Sunday that he thought Oklahoma was “the better team” before conceding that Ole Miss “out-executed us.”

“That’s an interesting take. That’s a hot take [that] they have the better team,” Kiffin said Monday when asked about Venables’ comments. “I wouldn’t have thought that people watching would say that.

“I felt that one, we won at their place in weather that — as a defensive head coach — you would normally wish for, and won by eight points. And I think we left a lot out there. I think we should have won by a couple of scores. So I don’t know how he evaluated that game that they were the better team.”

Kiffin cited Ole Miss’ 26-14 victory last season at home against Oklahoma before mentioning other previous games he has coached against Venables’ teams.

“Maybe they had the better team last year, too, when we beat them,” said Kiffin, who shrugged before apologizing for interrupting a reporter’s follow-up question. “Sorry … maybe he had the better team in Oklahoma, when we beat him 55-19 in the national championship — maybe.

“Maybe he had the better team at Clemson, when we beat him 45-40 in the national championship at Alabama. Next question, my bad.”

Kiffin was an assistant under Pete Carroll at USC when the Trojans beat the Sooners for the national title after the 2004 season. Venables was a defensive assistant on that Oklahoma team.

The coaches squared off again for the national championship 11 years later, when Kiffin was the offensive coordinator for the Nick Saban-coached Alabama team that beat Clemson for the NCAA title after the 2015 season. Venables was the Tigers’ defensive coordinator that year.

Kiffin’s Rebels were successful offensively Saturday against the Sooners, finishing with 431 yards of total offense against a Venables-coached team that led the nation in total defense and ranked second in scoring defense heading into the weekend.

“We had way more yards, 21 first downs to 14, and we played 87 plays of offense and they had one sack and didn’t force any turnovers,” Kiffin said. “That’s an interesting take. But whatever he needs to say.”

Ole Miss is scheduled to visit Oklahoma again next season. The Rebels (7-1, 4-1 SEC) host South Carolina in their next game Saturday, while the Sooners (6-2, 2-2) visit No. 14 Tennessee.

Continue Reading

Sports

$168M owed to fired FBS head football coaches

Published

on

By

8M owed to fired FBS head football coaches

Former LSU coach Brian Kelly’s $54 million buyout would bring the amount of money owed to FBS head football coaches fired this season to $167.7 million, according to publicly available data and reports.

Kelly’s buyout, which is still being negotiated with LSU, is the highest of the 2025 season so far, topping the $49 million owed to Penn State‘s ex-coach James Franklin, who was fired on Oct. 12.

Also included in the $167.7 million:

  • $21 million for Billy Napier, fired from Florida Oct. 19.

  • $15 million for Mike Gundy, fired from Oklahoma State Sept 23.

  • $9.8 million owned to Sam Pittman, fired from Arkansas Sept. 28.

  • $6 million for Brent Pry, fired from Virginia Tech Sept. 14.

  • $5 million for DeShaun Foster, fired from UCLA Sept. 14.

  • $4 million for Trent Bray, fired from Oregon State Oct. 12.

  • $2.4 million for Trent Dilfer, fired from UAB Oct. 12.

  • $1.5 million for Jay Norvell, fired from Colorado State Oct. 19.

Buyout totals are subject to change in certain circumstances; for example, if Kelly or Franklin land new jobs, the schools that fired them owe them less money. Napier’s contract with Florida, on the other hand, did not include offset language, and half of his buyout is owed to him within 30 days of his firing.

Kelly’s buyout is the second largest in college football history, behind Texas A&M‘s record $76 million buyout of Jimbo Fisher in 2023. Both coaches were hired by current LSU athletic director Scott Woodward, who ran the Texas A&M athletic department from 2016 to 2019.

“We had high hopes that [Kelly] would lead us to multiple SEC and national championships during his time in Baton Rouge,” Woodward said when he announced the firing, which came a day after the Tigers’ 49-25 loss to Texas A&M. “Ultimately, the success at the level that LSU demands simply did not materialize, and I made the decision to make a change after last night’s game.

The $168.1 million applies to coaches who have been fired since the start of the 2025 season and does not include coaches who were fired over the offseason.

Continue Reading

Trending