The Lancet Global Health

Global data indicate higher COVID-19 case fatality rates among men than women. Most countries with available data indicate a male to female case fatality ratio higher than 1·0, ranging up to 3·5 in some cases (appendix).1The Sex, Gender, and COVID-19 ProjectThe COVID-10 sex-disaggregated data tracker.https://globalhealth5050.org/covid19/Date accessed: September 18, 2020Google Scholar However, the COVID-19 case fatality rate is higher in women than men in a few countries, such as India, which is one of the worst-affected countries. As of Sept 30, 2020, India had more than 6·4 million recorded COVID-19 cases.2Johns Hopkins University of MedicineNew cases of COVID-19 in world countries.https://coronavirus.jhu.edu/data/new-casesDate accessed: October 3, 2020Google Scholar In India, the COVID-19 case fatality rate among men is 2·9% and 3·3% among women.3Joe W Kumar A Rajpal S Mishra US Subramanian SV Equal risk, unequal burden? Gender differentials in COVID-19 mortality in India.J Glob Health Sci. 2020; 2: e17Crossref Google Scholar Case fatality rates in Nepal, Vietnam, and Slovenia are also higher among women than men.1The Sex, Gender, and COVID-19 ProjectThe COVID-10 sex-disaggregated data tracker.https://globalhealth5050.org/covid19/Date accessed: September 18, 2020Google Scholar These findings are surprising since global data have indicated that both biological factors (stronger immune responses) and behavioural risk factors (eg, smoking, and other lifestyle habits) place men at a greater risk for health complications and death as a consequence of COVID-19.4Bwire GM Coronavirus: why men are more vulnerable to Covid-19 than women?.SN Compr Clin Med. 2020; 2: 874-876Crossref PubMed Google Scholar, 5Griffith DM Sharma G Holliday CS et al.Men and COVID-19: a biopsychosocial approach to understanding sex differences in mortality and recommendations for practice and policy interventions.Prev Chronic Dis. 2020; 17: E63Crossref PubMed Google Scholar Such differential findings on the association between sex and COVID-19 c...

Sex differences in COVID-19 case fatality: do we know enough?