The fact that men and women can suffer differently from the same diseases has long been known. With a high degree of probability, a heart attack in men will proceed differently than in women. Colon cancer in the fairer sex appears later and is treated better. But cirrhosis of the liver and osteoporosis more often affect women. Sex hormones also determine a person’s response to drugs. No wonder scientists and doctors have long been talking about the need to develop a separate area — gender medicine.

It turned out that COVID-19 has its own gender characteristics. In this case, men are the most affected. This pandemic turned out to be more dangerous for them than for women. And if in the first months of the pandemic the difference between the sexes seemed insignificant, today it becomes clear: it is men who are the weaker sex during the COVID-19 pandemic.

MedAboutMe found out the vulnerabilities of men in relationships with the SARS-CoV-2 coronavirus.

The incidence of COVID-19: features of biology

The incidence of COVID-19: features of biology

Despite anecdotal reports that men get sick more often than women, the bulk of the studies suggest that confirmed cases are evenly distributed between men (50%) and women (50%).

According to the study, the results of which were published in the journal Nature in August 2020, there was no difference between men and women in the concentration of coronavirus particles in either nasopharyngeal swabs or saliva. There was also no difference in the amount of antibodies produced — organisms of both sexes produce the same amount of antibodies on average.

Gender differences appear during the early immune response that occurs shortly after infection. Men produce more of the pro-inflammatory cytokines IL-8 and IL-18, meaning they are more likely to develop a cytokine storm.

At the same time, women have more activated T-lymphocytes, which are necessary for the destruction of viral particles. Men who had low T-lymphocyte levels were more likely to suffer from severe forms of COVID-19.

As a result, men with COVID-19 are admitted to the hospital a little more often (53%, that is, there are 11 men for 10 hospitalized women) and they are also more likely to be in intensive care (68%, 18 men for 10 women).

Mortality from COVID-19

Men are also more likely to die from coronavirus infection compared to women (58%). That is, for every 10 deaths in women, there are 13 deaths from COVID-19 among men.

According to CDC estimates, in the age group of 30-49 years, mortality among men is 2 times higher than the same indicator for women.

We add that higher mortality rates among men were also observed in other coronavirus infections caused by the SARS-CoV-1 and MERS-CoV viruses.

COVID-19 Prevention: Vaccinations and Masks

But men are vaccinated against COVID-19 a little less often than the fairer sex: for 10 cases of vaccination among women, there are only 9 vaccinations among men.

According to scientists from Fairleigh Dickinson University, published in February 2021, men are more skeptical about getting vaccinated against COVID-19 and wearing face masks.

Interestingly, a key factor in attitudes towards coronavirus protection is the propensity to demonstrate gender identity.

Thus, men who consider it important to show their masculinity to others, the so-called «macho», are less likely to report their intention to be vaccinated and are more likely to believe that the introduction of the vaccine will lead to the development of serious side effects (22% versus 19% of ordinary men). In general, 34% of “supermen” and only 27% of ordinary men say that COVID-19 vaccines have many severe side effects.

“Especially courageous” members of the stronger sex also wear masks less often. 10% of them are sure that wearing masks is dangerous to health compared to 6% of other men. 17% say masks are very uncomfortable compared to 13% of other men. 24% say «We live in a free country and no one will force me to wear a mask!» – only 17% of other men and 18% of the general population agree with them.

«Courageous» men are more likely to neglect other protection measures. Guests come to them more often, they visit crowded places more often. In general, such people are confident that they are strong enough to survive COVID-19.

As a result, «particularly courageous» men put themselves in greater danger, as the statistics show. According to the survey, among «carriers of gender identity», 2.2% of men were diagnosed with COVID-19, compared with 0.8% of the general male population and 1.4% of women (regardless of their gender predilections). That is, “supermen” are ill with COVID-19 3 times more often than ordinary men.

And even in testing for COVID-19 and antibodies to coronavirus, women overtake men. An analysis of global data collected in 16 countries around the world shows that for every 10 tests performed by women, only 8 tests are performed by men.

Gender, society and COVID-19

Gender, society and COVID-19

There is another important point: the social effect of the pandemic. Perhaps the burden of circumstances turned out to be heavier for men — this led to their deplorable situation? But no.

According to an article published in Nature in the summer of 2020, the social and economic consequences of the pandemic are more pronounced on women. They take on the main care for sick family members, during lockdowns it is on their shoulders that the multiply increasing burden of providing for their loved ones falls on their shoulders, they also usually face the problem of children’s activities during the closure of kindergartens and schools. And even in turbulent times, women lose their jobs more often than men. And this is not to mention the multifold increase in the level of domestic violence and one of its manifestations — the increase in the number of abortions.

During the Ebola outbreak in West Africa a few years ago, the closure of the market resulted in the loss of jobs for traders, 85% of whom were women. A year later, 63% of the men returned to their seats, but only 17% of the women were able to do the same.

So, there is a biological gender difference between men and women. However, it is not large enough to explain the much larger difference in severe COVID-19 incidence and mortality among men.

Experts believe that the behavior of the stronger sex plays an equally important role. What can be done to reduce risks for men during a pandemic?

Convince them that «machism» does not mean neglecting safety measures. You can remain a “courageous superman” after being vaccinated against COVID-19, with a mask on your face, and with test results in your pocket. Taking care of your health in our time is not a sign of weakness, but an indicator of responsibility for your life and for the lives of other people.

Expert comment

Co-Director of GH5050, Professor Sarah Hawkes

The pandemic has opened our eyes to the fact that health is determined not only by human biology, but also by the social environment in which we all find ourselves. And gender differences are an important determining factor.

Women are most affected by pandemics — lessons from past outbreaks / Clare Wenham et al // Nature July 08, 2020

Sex differences in immune responses that underlie COVID-19 disease outcomes. / Takahashi T, et al. // Nature Dec 2020 588(7837)

Demographic Trends of COVID-19 cases and deaths in the US reported to CDC // CDC May 3, 2021

FDU Poll finds masculinity is a major risk factor for COVID-19 // FDU February 16, 2021

The COVID-19 Sex-Disaggregated Data Tracker // Global Health 5050 April 27, 2021