Sex differences in COVID-19

Published

2 years ago

March 25, 2023

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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 Some information may be out of date.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.

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. 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 could place them at a higher risk of ontracting 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.

Politics

No 10 decline to say if Palestine will be recognised with Hamas in power

Published

1 hour ago

August 4, 2025

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No 10 decline to say if Palestine will be recognised with Hamas in power

The prime minister’s spokesman has refused eight times to confirm whether recognition of Palestine could go ahead if Hamas remain in power and the hostages are not released.

Keir Starmer’s spokesman was questioned by journalists for the first time since the announcement last week that the UK will formally recognise the state in September – unless Israel meets certain conditions including abiding by a ceasefire and increasing aid.

The policy has been criticised by the families of UK hostages, campaigners and some Labour MPs, who argue it would reward Hamas and say it should be conditional on the release of the remaining hostages.

A senior Hamas politician, Ghazi Hamad, speaking to Al Jazeera, said at the weekend that major nations’ decision to recognise a Palestinian state “is one of the fruits of 7 October”.

Gaza latest: Trump pressed to recognise Palestinian state

The PM’s spokesman said on Monday: “The PM is clear that on 7 October, Hamas committed the worst act of terror in Israel’s history. That horror has continued since then.

“As the foreign secretary said over the weekend, Hamas are rightly pariahs who can have no role in Gaza’s future, there is a diplomatic consensus on that. Hamas must immediately release all hostages and have no role in the governance of Gaza.”

But asked whether removing Hamas from power and releasing hostages were conditions for statehood, he said a decision on recognition would be made at the UN General Assembly meeting in September, based on “an assessment of how far the parties have met the steps we have set out. No one side will have veto on recognition through their actions or inactions.”

He added: “Our focus is on the immediate situation on the ground, getting more aid in to end the suffering in Gaza and supporting a ceasefire and a long-term peace for Israelis and Palestinians based a two-state solution.”

Starmer, who recalled his cabinet for an emergency meeting last week before setting out the new position, is following the lead of French president Emmanuel Macron, who first pledged to move toward recognising Palestinian statehood in April.

Canada has also backed recognition if conditions are met, including by the Palestinian Authority.

The prime minister had previously said he would recognise a state of Palestine as part of a contribution to a peace process.

In his announcement last Tuesday, he said: “We need to see at least 500 trucks entering Gaza every day. But ultimately, the only way to bring this humanitarian crisis to an end is through a long-term settlement.

“So we are supporting the US, Egyptian and Qatari efforts to secure a vital ceasefire. That ceasefire must be sustainable and it must lead to a wider peace plan, which we are developing with our international partners.

“I’ve always said we will recognise a Palestinian state as a contribution to a proper peace process, at the moment of maximum impact for the two-state solution. With that solution now under threat, this is the moment to act.”

Adam Rose, a lawyer acting for British families of hostages in Gaza, has said: “Why would Hamas agree to a ceasefire if it knew that to do so would make British recognition of Palestine less likely?”

Environment

EcoFlow DELTA 2 Max solar bundle $1,139 low, Lectric ONE e-bike gets $319 in free gear, Anker SOLIX C300 90,000mAh stations, more

Published

1 hour ago

August 4, 2025

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EcoFlow DELTA 2 Max solar bundle ,139 low, Lectric ONE e-bike gets 9 in free gear, Anker SOLIX C300 90,000mAh stations, more

We’re starting this week’s Green Deals with EcoFlow’s August Home Backup Sale that is seeing up to 59% initial discounts, bonus savings, continued 3x and 3.5x EcoCredit rewards, new free gift promotions, and more – with plenty of ongoing low prices like the DELTA 2 Max Solar Generator bundle that gives you a 220W panel at its $1,139 low, among many others. We also have Lectric’s ONE Long-Range e-bike getting the biggest $319 bundle of 2025 at $2,399, as well as Anker’s SOLIX C300 90,000mAh Power Stations and bundle options starting from $170. From there, we also have EcoFlow’s latest 48-hour flash sale on two power station bundles and a dual solar panel option, alongside the best price of the year on Worx’s 20V JawSaw PowerShare Cordless Chainsaw.Plus, all the hangover savings from last week are at the bottom of the page, rounded together in our Electrified Weekly coverage, which includes the new EcoFlow TRAIL releases, exclusive Bluetti Apex 300 launch savings, and much more.

Head below for other New Green Deals we’ve found today and, of course, Electrek’s best EV buying and leasing deals. Also, check out the new Electrek Tesla Shop for the best deals on Tesla accessories.

Save up to 59% on EcoFlow power stations and backup bundles with bonus savings, free gifts, up to 3.5x EcoCredits – all from $179

EcoFlow has launched a new Home Backup Sale through August 17 that is continuing some of the Monthly Madness rewards from last week while adding new free gift promotions and extra savings – with this event running parallel to the brand’s release of the new TRAIL series power stations. One of the notable low prices we’re seeing during this period is on EcoFlow’s DELTA 2 Max Solar Generator bundle that comes with a 220W solar panel for $1,139.05 shipped, after using the code 25EFDCAFF at checkout for an additional 5% off your order, which beats out Amazon’s current pricing by $60. Normally going for $2,548 in full here, over the last seven months we’ve seen discounts take things to their lowest for $1,139 back during last month’s Prime Day event, with prices otherwise keeping at or above $1,199. That low price is coming back thanks to the bonus savings, giving you $1,409 in savings and the best price we have tracked.

As previously mentioned, this Home Backup Sale is seeing some continuations alongside some new free gift promotions. Of course, there’s the extra 5% savings you’ll get using the code 25EFDCAFF at checkout, but standard members will also be getting 3x EcoCredits from orders, while Plus members get 3.5x EcoCredits – which you can use to score future discounts and other exchanged rewards. If you already have some saved, you can spend 500 to unlock a spin on the brand’s Lucky Draw wheel for guaranteed gifts/savings. There’s also the chance to get a free refurbished RIVER 2 Max power station with purchases of select DELTA series units.

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For folks not wanting to spend too much on larger whole-home backup systems but want to maintain their peace of mind during trips away from home and possible at-home outage emergencies, EcoFlow’s DELTA 2 Max is a solid option that starts with a 2,048Wh LiFePO4 capacity and can expand as high as 6,144Wh with add-on expansion batteries. It pumps out a steady stream of 2,400W of power through its 15 output port options, with the ability to surge up to 3,400W once you’ve activated its X-Boost mode in the remote app controls. A wall outlet can bring the battery back to 83% in 1.1 hours, with the option to plug it into your car’s auxiliary port to charge as you drive, on top of a max 1,000W solar input that can also be used simultaneously with a wall outlet for faster 43-minute charge times.

If you just want EcoFlow’s DELTA 2 Max power station by itself, you can pick it up at $996.55 shipped, after using the 5% off code, while bundling EcoFlow’s DELTA 2 Max with an 800W alternator charger that tops it off faster than a car auxiliary port will cost you $1,139.05 shipped, after using the extra savings code.

You can browse the full lineup during this EcoFlow August Home Backup Sale by checking out our original coverage of these deals here.

man riding down sidewalk on Lectric ONE e-bike

Lectric’s 60-mile traveling ONE e-bike with a Gates carbon belt drive gets largest $319 bundle of 2025 at $2,399

Looking in on Lectric’s ongoing Back to School Sale, we wanted to shine a spotlight on the biggest bundle we’ve seen accompany the brand’s ONE Long-Range e-bike at $2,399 shipped, which is getting $319 in free gear that includes a rear cargo rack, fenders to go over the tires, and a 4-liter frame bag. This package would normally run you $2,718 at full price, if it weren’t for the brand’s trend of offering savings on the bundles. While we did see it get a $308 bundle back in February, this model has otherwise only been getting $220 in free gear this year, but now, during this sale, we’re seeing a larger bundle than ever in 2025.

If you want to learn more about this model, be sure to check out our original coverage of this deal here, while you can also check out the full lineup of Back to School e-bike deals from this brand here.

man hiking through woods with Anker SOLIX C300 DC power station hanging from shoulder

Anker’s SOLIX C300 power stations are portable 90,000mAh backup companions that start from $170 (up to 32% off)

By way of its official Amazon storefront, Anker is offering its SOLIX C300 DC Portable Power Station at $169.99 shipped, beating out the brand’s direct website pricing by $20. You’d have to pay $250 for this unit at full price regularly, though discounts in 2025 have seen it go as low as $150, which was last seen in July’s Prime Day Sale event, with things otherwise seen repeating to $170 since June. This is the third-lowest price we have tracked, giving you $80 off the going rate and landing $30 above the all-time low from Black Friday and Christmas sales.

If you want to learn more about this model or get the rundown on its predecessor and bundle options, be sure to check out our original coverage of these deals here.

four people enjoying camping in tent with EcoFlow DELTA 2 power station with extra battery bundle

Save up to 62% on DELTA 2 and DELTA Pro bundles, as well as dual solar panels, starting from $499 for 48 hours

Alongside launching its latest Home Backup Sale that is running through August 17, EcoFlow has also launched a 48-hour flash sale that is taking up to 62% off three offers, with things starting lowest on the DELTA 2 Portable Power Station that comes bundled with a smart extra battery for $899 shipped, which beats out its Amazon pricing by $50. This bundle would cost you $1,798 at full price directly from the brand, while we’ve seen it more regularly at $1,289 at Amazon. Discounts this year have seen it fall to $799 back in March, with things otherwise dropping between $849 and $999 during sales. You’re looking at a 50% markdown off its MSRP here and the third-lowest price of 2025, while the savings last through today and tomorrow.

If you want to learn more about this bundle or the two other offers, be sure to check out our original coverage of this flash sale here.

man cutting thick tree branch with Worx 20V JawSaw cordless chainsaw

Worx’s 20V JawSaw chomps through thick branches with a retractable blade at $101

Amazon is offering the best price of the year on Worx’s 20V JawSaw PowerShare Cordless Chainsaw at $101.40 shipped. Most of the past year we’ve seen this more unique chainsaw keeping up at a full $170 rate, which we saw drop to $130 during Black Friday and Christmas sales and more recently fell to $109 at the top of July. While it has dropped as far as $89 in past years, today’s deal comes in lower than we’ve seen in the last 12 months, giving you $69 off the going rate and beating out our previous mention by $8.

If you want to learn more about this unique chainsaw, be sure to check out our original coverage of this deal here.

Best Summer EV deals!

Aventon Ramblas Electric Mountain Bike: $2,599 (Reg. $2,899)
Ride1Up Prodigy v2 Brose Mid-Drive Gates Belt CVT e-bike: $2,595 (Reg. $2,795)
Ride1Up Revv 1 DRT Off-Road Moped-Style e-bike: $2,395 (Reg. $2,595)
Ride1Up Revv 1 Full Suspension Moped-Style e-bike: $2,395 (Reg. $2,595)
Rad Power RadRunner Max Cargo Utility e-bike with $139 bundle: $2,299 (No price cut)
Segway Xafari Red e-bike: $2,000 (Reg. $2,400)
Velotric Nomad 2 All-Terrain e-bike with $120 bundle (new model): $1,999 (No price cut)
Rad Power Radster Road Commuter e-bike: $1,999 (Reg. $2,199)
Rad Power Radster Trail Off-Road e-bike: $1,999 (Reg. $2,199)
Lectric XPedition 2.0 35Ah Cargo e-bike w/ up to $654 bundle: $1,999 (Reg. $2,653)
Ride1Up Prodigy v2 Brose Mid-Drive 9-Speed e-bike: $1,995 (Reg. $2,495)
Tenways AGO X All-Terrain e-bike with $307 bundle: $1,899 (Reg. $2,499)
Velotric Breeze 1 Cruiser e-bike with $150 bundle (new model): $1,799 (No price cut)
Aventon Pace 4 Smart Cruiser e-bike (new model, first discount): $1,699 (Reg. $1,799)
Lectric XPedition 2.0 26Ah Cargo e-bike w/ $505 bundle: $1,699 (Reg. $2,204)
Lectric XPeak 2.0 Long-Range Off-Road e-bike with $316 bundle: $1,699 (Reg. $2,015)
Aventon Aventure 2 All-Terrain e-bike: $1,699 (Reg. $1,999)
Aventon Abound Cargo e-bike: $1,599 (Reg. $1,999)
Rad Power RadRunner Cargo Utility e-bike with $109 bundle: $1,499 (No pirce cut)
Lectric XPeak 2.0 Standard Off-Road e-bike with $227 bundle: $1,499 (Reg. $1,726)
Lectric XP Trike2 with $227 preorder bundle: $1,499 (Reg. $1,726)
Rad Power RadWagon 4 Cargo e-bike: $1,499 (Reg. $1,799)
Tenways CGO600 Pro e-bikes with $118 bundle: $1,499 (Reg. $1,899)
Velotric Nomad 1 Plus All-Terrain e-bike: $1,499 (Reg. $1,899)
Aventon Sinch 2 Folding e-bike (lowest price): $1,399 (Reg. $1,699)
Lectric XPedition 2.0 13Ah Cargo e-bike with $326 bundle: $1,399 (Reg. $1,725)
Aventon Level 2 Commuter e-bike (2025 low): $1,399 (Reg. $1,899)
Ride1Up Roadster V3 Lightweight Premium e-bike: $1,395 (Reg. $1,495)
Velotric T1 ST Plus Lightweight e-bike: $1,399 (Reg. $1,649)
Lectric XPress 750 Commuter e-bikes with $366 bundle: $1,299 (Reg. $1,665)
Lectric XP4 750 LR Folding Utility e-bikes with $356 bundle: $1,299 (Reg. $1,655)
Lectric XP Lite 2.0 JW Black LR e-bike with $365 bundle: $1,099 (Reg. $1,464)
Ride1Up Portola Folding e-bike with BOGO accessory promo: $995 (Reg. $1,095)
Lectric XP4 Standard Folding Utility e-bikes with $79 bundle: $999 (Reg. $1,078)
Lectric XP Lite 2.0 Long-Range e-bikes with up to $365 bundles: $999 (Reg. $1,364)
Heybike Hauler Single-Battery Cargo e-bike: $999 (Reg. $1,499)
Rad Power RadExpand 5 Folding e-bike (new low): $999 (Reg. $1,599)
Navee ST3 Pro Electric Scooter (new model): $760 (Reg. $1,014)
ENGWE Engine Pro Folding e-bike (use code 9TO5ENGWE50): $750 (Reg. $1,500)
Navee GT3 Pro Electric Scooter (new model): $520 (Reg. $714)

Best new Green Deals landing this week

The savings this week are also continuing to a collection of other markdowns. To the same tune as the offers above, these all help you take a more energy-conscious approach to your routine. Winter means you can lock in even better off-season price cuts on electric tools for the lawn while saving on EVs and tons of other gear.

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