Why is coronavirus more deadly for men than women?

Scientists have begun exploring the use of female sex hormones as a treatment to boost men’s chances of surviving the coronavirus.

According to Office for National Statistics (ONS) figures released this month, men are twice as likely to die from Covid-19 than women in all older age groups.

The mortality rate for men who died due to coronavirus was 97.5 deaths per 100,000 population, while for women it was 46.6 deaths per 100,000, the ONS said. Including cases where Covid-19 was mentioned anywhere on the death certificate, the death rate for men was 113.1 per 100,000 for men and 54.1 per 100,000 for women.

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In total in Britain, about 60% of Covid-19 patients admitted to hospital have been male, and once admitted, a woman is about 20% less likely to die. Three quarters of the hospital’s intensive care patients are men.

This pattern is consistent with data from around the world. Business Insider notes that as early as late February, several studies of people infected with coronavirus in China confirmed variously that men were more likely to be infected, and to die from it.

“Similar findings came in later studies in South Korea and Italy, and by April 12 the pattern was repeated in data from more than 20 countries,” the site adds.

Why are men more at risk?

Speaking to The Daily Telegraph, Paul Hunter, professor of medicine at the University of East Anglia, said: “Women seem to have more powerful immune systems, which means they suffer more from autoimmune disease like rheumatoid arthritis, when the immune system responds over-aggressively and ends up attacking the body.”

Hunter added: “This happens in men far less frequently, but it appears to be a good thing for a number of infections and particularly influenza, and there is evidence women produce better antibody responses to the influenza vaccine than men.”

CNN reports that across the countries for which it has data - spanning nearly a quarter of the world’s population - it found that men were 50% more likely than women to die after being diagnosed with Covid-19.

“While necessarily partial and incomplete, the results highlight what public health experts have been warning for some time, theorising that it is not only biology but also gendered behaviors... which may play a significant role in the different mortality rate for respiratory diseases,” the broadcaster reports.

Smoking and drinking have been suggested as an early explanation behind the gender disparity, with The New England Journal of Medicine noting that nearly 50% of men in China smoking compared to only about 2% of women.

“Probably not coincidentally”, reports The Independent, men in China, Italy and South Korea which have seen the highest number of Covid-19 deaths, “also tend to die more frequently from heart disease, cancer, diabetes and respiratory diseases between ages 30 and 70”.

“Behavioural factors that differ across genders may also have a role”, says The Guardian, saying studies have shown that men are less likely to wash their hands, less likely to use soap, less likely to seek medical care and more likely to ignore public health advice.

“These are sweeping generalisations, but across a population could place men at greater risk,” the paper adds.

What can be done?

The Times reports that two groups of scientists in the United States are now looking at whether sex hormones might boost men's chances.

Sharon Nachman, who is leading one trial at the Renaissance School of Medicine at Stony Brook University, Long Island, told the paper: “It’s rare to see a disease with this incredible predilection for men.”

Her team will oversee around 100 subjects, either men over the age of 18 or women over 55, who will trial a patch containing the hormone attached to their skin for a week.

Another trial at the Cedars-Sinai hospital in Los Angeles will involve patients being given the hormone progesterone, which has anti-inflammatory properties.

Preliminary results are expected within a few months.

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