Sex differences in patients with COVID-19: a retrospective cohort study and meta-analysis

BACKGROUND: Accumulated evidence revealed that male was much more likely to higher severity and fatality by SARS-CoV-2 infection than female patients, but few studies and meta-analyses have evaluated the sex differences of the infection and progression of COVID-19 patients. AIM: We aimed to compare the sex differences of the epidemiological and clinical characteristics in COVID-19 patients; and to perform a meta-analysis evaluating the severe rate, fatality rate, and the sex differences of the infection and disease progression in COVID-19 patients. METHODS: We analyzed clinical data of patients in Changchun Infectious Hospital and Center, Changchun, Northeast China; and searched PubMed, Embase, Web of Science, and Cochrane Library without any language restrictions for published articles that reported the data of sex-disaggregated, number of severe, and death patients on the confirmed diagnosis of adult COVID-19 patients. RESULTS: The pooled severe rate and fatality rate of COVID-19 were 22.7% and 10.7%. Male incidence in the retrospective study was 58.1%, and the pooled incidence in male was 54.7%. CONCLUSION: The pooled severe rate in male and female of COVID-19 was 28.2% and 18.8%, the risky of severe and death was about 1.6folds higher in male compared with female, especially for older patients (> 50 y).