A new Houston Methodist study out this week found males are more likely to test positive for COVID-19, have complications and die from the virus than females, independent of age.


“Males seem to be more likely to contract the SARS-CoV-2 virus and also have a poor clinical course and outcomes related to COVID-19, compared to females,” said the study’s corresponding author, Farhaan Vahidy, Ph.D., M.B.B.S., M.P.H. of the Houston Methodist Research Institute and associate director of the Center of Outcomes Research at Houston Methodist. “The exact contribution of gender and sex factors in susceptibility and outcomes of COVID-19 need further investigation.”


The peer-reviewed observational study appears in PLOS ONE, a multidisciplinary journal published by the Public Library of Science, which is a nonprofit open-access publisher and advocacy organization dedicated to accelerating progress in science and medicine.


As the COVID-19 pandemic unfolds and evolves across the globe, researchers have identified population sub-groups with higher levels of disease vulnerability, such as those with advanced age or certain pre-existing conditions. Small studies from China and Europe have indicated that males tend to experience higher disease severity compared to females. However, a comprehensive gender analysis of COVID-19 in a large and diverse U.S. metropolitan area has been lacking.


To determine the associations between sex and COVID-19 epidemiology, researchers used data from the Houston Methodist COVID-19 Surveillance and Outcomes Registry, which is an IRB-approved observational research registry for COVID-19 patients that tracks socio-demographic, comorbidity, clinical and outcomes data on all individuals tested for SARS-CoV-2 across Houston Methodist’s system of eight hospitals. Data on COVID testing, hospital stays, mortality and demographics were extracted from Electronic Medical Records of all 96,496 adults over 18 who were tested for SARS-CoV-2 by the health system between March 6 and Aug. 22, 2020.


Overall, 15.5% of individuals in the cohort tested positive for SARS-CoV-2. After adjusting for sociodemographic factors and comorbidities, males had a higher likelihood of SARS-CoV-2 positivity than females. Similarly, the proportion of patients requiring ICU care was significantly higher among males at 34.1% as compared to females at 27.6%. Moreover, 19.0% of males underwent mechanical ventilation, compared to 14.7% of females, and the proportion of males who experienced in-hospital mortality was significantly higher at 11.6% as compared to 8.3% of females. The authors conclude that there is a clear and strong independent association between male sex and SARS-CoV-2 susceptibility, complications and poor outcomes and say that understanding gender differences in the disease is a fundamental step toward improved disease management and intervention strategies for both men and women.


The findings are described in a paper titled “Sex differences in susceptibility, severity, and outcomes of coronavirus disease 2019: Cross-sectional analysis from a diverse US metropolitan area,” appearing Jan. 13 in PLOS ONE. Other collaborators working with Vahidy on this study were Alan P. Pan, Hilda Ahnstedt, Yashasvee Munshi, Huimahn A. Choi, Yordanos Tiruneh, Khurram Nasir, Bita A. Kash, Julia D. Andrieni and Louise D. McCullough.