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Healthy & Fitness Article

Sex differences in the new coronavirus

Sex differences in the new coronavirus

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.

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The data that are available so far indicate that there are significant differences between how the sexes respond to the new coronavirus.

There are many ways in which the pandemic itself affects people’s 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.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

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.

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,

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