Abstract
Males are at a higher risk of dying from COVID-19 than females. Older age and cardiovascular disease are also associated with COVID-19 mortality. To better understand how age and sex interact in contributing to COVID-19 mortality, we stratified the male-to-female (sex) ratios in mortality by age group. We then compared the age-stratified sex ratios with those of cardiovascular mortality and cancer mortality in the general population. Data were obtained from official government sources in the US and five European countries: Italy, Spain, France, Germany, and the Netherlands. The sex ratio of deaths from COVID-19 exceeded one throughout adult life, increasing up to a peak in midlife, and declining markedly in later life. This pattern was also observed for the sex ratio of deaths from cardiovascular disease, but not cancer, in the general populations of the US and European countries. Therefore, the sex ratios of deaths from COVID-19 and from cardiovascular disease share similar patterns across the adult life course. The underlying mechanisms are poorly understood and warrant further investigation.
Highlights
More males than females die from COVID-19, the disease caused by SARS-CoV-2
We examined the sex ratio of cardiovascular disease (CVD) mortality by age in these countries (Figure 2, Supplementary Figure 2)
Our key findings are as follows: (i) for all age groups, the death rate from COVID-19 was higher in males than females; (ii) the sex mortality ratio for COVID-19 rose to a peak in midlife and narrowed with increasing age; and (iii) the sex mortality ratio for COVID-19 by age mirrored that for CVD but not cancer
Summary
More males than females die from COVID-19, the disease caused by SARS-CoV-2. This was first observed in China, where 64% of COVID-19 deaths occurred in males [1]. The higher number of deaths among males is consistent with mortality patterns observed in several major viral epidemics/pandemics of the 20th and 21st centuries, including the Western African Ebola virus epidemic (2013-2016) [2] and the H1N1 Spanish Flu pandemic of 1918 [3]. Seasonal influenza causes relatively more pediatric deaths, especially in infants under the age of six months [7], in addition to a disproportionate number of deaths in older adults over the age of 65 years [8]. Several major viral pandemics of the 20th and www.aging-us.com
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