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Age-dependent Gender Differences in COVID-19 in Mainland China: Comparative Study.
Qian, Jie; Zhao, Lin; Ye, Run-Ze; Li, Xiu-Jun; Liu, Yuan-Li.
  • Qian J; School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
  • Zhao L; Ecohealth Institute, School of Public Health, Shandong University, Jinan, Shandong, China.
  • Ye RZ; Ecohealth Institute, School of Public Health, Shandong University, Jinan, Shandong, China.
  • Li XJ; Ecohealth Institute, School of Public Health, Shandong University, Jinan, Shandong, China.
  • Liu YL; School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Clin Infect Dis ; 71(9): 2488-2494, 2020 12 03.
Article in English | MEDLINE | ID: covidwho-430202
ABSTRACT

BACKGROUND:

The ongoing pandemic of novel coronavirus disease 2019 (COVID-19) is challenging the global public health system. Sex differences in infectious diseases are a common but neglected problem.

METHODS:

We used the national surveillance database of COVID-19 in mainland China to compare gender differences in attack rate (AR), proportion of severe and critical cases (PSCC), and case fatality rate (CFR) in relation to age, affected province, and onset-to-diagnosis interval.

RESULTS:

The overall AR was significantly higher in females than in males (63.9 vs 60.5 per 1 million persons; P ˂ .001). In contrast, PSCC and CFR were significantly lower among females (16.9% and 4.0%) than among males (19.5% and 7.2%), with odds ratios of 0.87 and 0.57, respectively (both P ˂ .001). The female-to-male differences were age dependent, and were significant among people aged 50-69 years for AR and in patients aged 30 years or older for both PSCC and CFR (all P ≤ .001). The AR, PSCC, and CFR varied greatly from province to province. However, female-to-male differences in AR, PSCC, and CFR were significant in the epicenter, Hubei province, where 82.2% confirmed cases and 97.4% deaths occurred. After adjusting for age, affected province, and onset-to-diagnosis interval, the female-to-male difference in AR, PSCC, and CFR remained significant in multivariate logistic regression analyses.

CONCLUSIONS:

We elucidate an age-dependent gender dimorphism for COVID-19, in which females have higher susceptibility but lower severity and fatality. Further epidemiological and biological investigations are required to better understand the sex-specific differences for effective interventions.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sex Factors / Population Surveillance / Age Factors / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2020 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sex Factors / Population Surveillance / Age Factors / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2020 Document Type: Article Affiliation country: Cid