Sex differences in the mortality rate for coronavirus disease 2019 compared to other causes of death: an analysis of population-wide data from 63 countries

  1. Pascal Geldsetzer
  2. Trasias Mukama
  3. Nadine Kamel Jawad
  4. Tim Riffe
  5. Angela Rogers
  6. Nikkil Sudharsanan

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Abstract

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  1. Version published to 10.1007/s10654-022-00866-5
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    SciScore for 10.1101/2021.02.23.21252314: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableWe then obtained age- and sex-disaggregated data on all-cause mortality and population size for each of these countries from the Human Mortality Database (HMD) 12 and, for countries not included in the HMD, from the United Nation’s World Population Prospects (WPP) 10. Submitted Manuscript: Confidential Period/year† 2015-2020 2015-2020 2018 2018 2015-2020 2018 2015-2020 2017 2015-2020 2018 2015-2020 2015-2020 2018 2019 2015-2020 2019 2015-2020 2019 2018 2017 2017 2017 2018 2015-2020 2015-2020 2017 2016 2017 2019 3 Date* 28.11.2020 15.01.2021 07.02.2021 07.02.2021 01.02.2021 22.09.2020 21.10.2020 13.01.2021 07.02.2021 20.12.2020 24.05.2020 29.11.2020 07.02.2021 02.02.2021 31.07.2020 13.12.2020 30.12.2020 20.12.2020 28.01.2021 07.02.2021 16.01.2021 29.11.2020 29.11.2020 02.10.2020 24.05.2020 20.12.2020 09.12.2020 05.01.2021 18.08.2020 COVID-19 mortality Deaths Female Male 381 1,130 19,648 26,539 468 441 10,880 10,479 84,023 111,936 4,516 4,672 27 65 7,449 9,986 22,852 40,064 345 332 33 49 40 103 7,167 9,327 995 1,165 3,590 7,025 131 97 78 106 270 402 22,052 30,657 29,827 31,839 2,241 3,199 296 293 45 60 30,987 69,888 50 110 971 1,029 1,260 1,672 32,481 42,567 294 531 Country Afghanistan Argentina Australia Belgium Brazil Canada Chad Chile Colombia Croatia Cuba Cyprus Czechia Denmark Ecuador Estonia Eswatini Finland France Germany Greece Hungary Iceland India Iraq Ireland Israel Italy Japan Population (000s) Female Male 18,952 19,976 23,147 22,049 12,495 12,298 5,794 5,630 108,124 104,436 18,513 18,249 8,226 8,200 8,923 8,573 25,898 24,985 2,124 1,982 5,703 5,623 604 604 5,390 5,220 2,917 2,889 8,819 8,824 699 626 590 570 2,795 2,723 33,419 31,324 41,824 40,697 5,549 5,222 5,122 4,675 171 178 662,903 717,101 19,865 20,358 2,413 2,365 4,268 4,195 31,121 29,404 63,705 60,392 All-cause mortality Deaths (000s) Female Male 549 646 802 878 76 82 57 54 2,901 3,790 139 144 445 490 51 56 617 742 27 26 239 266 20 22 56 57 27 27 188 243 8 7 24 29 27 27 300 297 475 458 61 63 68 64 1 1 22,515 26,158 417 492 15 15 22 22 340 311 674 Submitted Manuscript: Confidential 2015-2020 2015-2020 2017 2019 2019 2015-2020 2015-2020 2015-2020 2015-2020 2018 2015-2020 2015-2020 2015-2020 2015-2020 2015-2020 2015-2020 2018 2018 2015-2020 2017 2017 2018 2018 2018 2015-2020 2015-2020 2013 2018 2015-2020 2018 5,037 27,053 1,054 1,499 305 9,696 220 65,861 15,788 8,654 101,670 107,220 2,155 3,508 16,593 54,552 19,840 5,425 9,884 2,784 1,041 25,680 23,776 4,278 4,159 42,703 24,407 33,554 1,795 165,365 5,166 26,719 896 1,296 309 9,434 221 63,071 13,348 8,527 104,470 113,672 2,160 3,624 16,379 55,029 18,593 4,869 9,354 2,652 1,025 25,595 22,881 4,206 4,119 41,636 20,961 32,687 1,678 160,460 84 641 15 20 2 274 9 1,688 437 79 5,546 3,364 44 85 374 1,249 201 56 621 26 10 138 210 35 164 997 338 312 81 1,381 104 761 14 18 2 333 9 2,058 460 75 6,038 3,974 61 104 491 1,836 214 57 654 27 10 161 215 32 170 1,201 325 304 82 1,458 Table 1.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has several limitations. First and foremost, this study can only provide suggestive (as opposed to conclusive) evidence as to whether or not the causal pathways underlying the male disadvantage for COVID-19 mortality are shared with those underlying the all-cause mortality disadvantage for men. Second, our mortality rate calculations for COVID-19 use the total population (by sex) as the denominator. Thus, the assumption underlying the validity of our calculation is that there are no substantial differences in the probability of being infected with SARS-CoV-2 between males and females. To date, evidence from seroprevalence studies suggests that this assumption is reasonable 17,18. An alternative approach is to use the number of identified cases of SARS-CoV-2 infections as the denominator (i.e., calculating the case fatality rate). This approach, however, assumes that the degree of underdetection of SARS-CoV-2 infections is the same among men as among women. This assumption would, for example, be violated if males are more likely to develop symptoms from a SARS-CoV-2 infection than females and are, therefore, more likely to seek out a COVID-19 test, or if men have better access to testing than women. Although both choices for the denominator (total population or number of cases) rely on untestable assumptions, our analyses in which we use the number of cases instead of the total population as denominator found that the choice of denominator does not substantially cha...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2021.02.23.21252314v1 on medRxiv