Why COVID-19 Hits Men Harder Than Women

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Nearly 38 million people worldwide have been infected by the coronavirus since the start of the pandemic. And it turns out that men are faring worse than women in the battle against COVID-19.

At the height of New York’s coronavirus crisis, the number of deaths among men was nearly double that of women. Throughout the U.S., the statistics aren’t quite as startling, but men still make up the majority (54 percent) of all COVID-19 deaths, even though women account for a larger share of confirmed cases, according to data from the Centers for Disease Control and Prevention (CDC). And in certain age groups, the gap is even wider.

Among adults ages 40 to 49, men account for 69 percent of COVID-19 deaths; and in 50- to 64-year-olds, they make up 66 percent of deaths. Men of all ages are also more likely than women to require intensive care or mechanical ventilation once hospitalized for COVID-19, CDC data shows. Globally, for every 10 females admitted to the intensive care unit (ICU), there are 18 coronavirus-related ICU admissions for men, the nonprofit Global Health 50/50 reports.

“All around the world, male sex is a risk factor for severe COVID [illness] and mortality,” says Akiko Iwasaki, a professor of immunobiology at Yale School of Medicine. And experts have a few clues as to why this is the case.

Researchers uncover sex differences in immune response

One explanation researchers have zeroed in on: Men don’t produce as powerful an immune response as women. In a recent study, Iwasaki and her colleagues followed about 40 COVID-19 patients admitted to the Yale New Haven Hospital between March 18 and May 9, and found a few key differences in how men and women responded to the disease biologically.

For starters, “male patients had a difficult time developing T cell immune response, whereas female patients had much better T cell activation,” explains Iwasaki, whose research was recently published in the journal Nature. T cells help protect the body from an infection and keep it from spreading.

Male patients who developed a diminished T cell response “ended up doing worse with the disease,” Iwasaki notes. “Whereas female patients were able to mount a T cell response and were able to control the virus infection.” T cell activation was especially low in older male patients, but not in older female patients, which may explain the disparity in deaths between men and women in certain age groups.

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