COVID-19 hospitalization and mortality: Sex differences

Males with COVID-19 had significantly higher rates of hospitalization and of transfer to the intensive care unit (ICU), according to a new study. A higher percentage of males died of COVID-19 than females, as reported in the study published in the peer-reviewed Journal of Women's Health.

Joanne Michelle Gomez, MD, Rush University Medical Center, and coauthors studied the first 8,108 positive COVID-19 patients that presented to the Rush University System from March 1-June 21, 2020. Nineteen percent of males required hospitalization, compared to 13% of females. Eight percent of males compared to 4% of females required escalation of care to the ICU. The authors also reported significantly greater need for vasopressor support and endotracheal intubation among males.

"A significant independent association was observed between male sex and in-hospital mortality when accounting for the total cohort of positive COVID-19 patients," state the authors. "The interplay among biological, hormonal, and gendered behavioral factors is likely responsible for the worse outcomes observed in males in COVID-19 infection."

"The findings of this study clearly demonstrate better outcomes for females infected with COVID-19. The authors propose some of the biological, hormonal, and behavioral factors that could be protective in females," says Journal of Women's Health Editor-in-Chief Susan G. Kornstein, MD, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA.