Why do men have worse COVID-19-related outcomes? A systematic review and meta-analysis with sex adjusted for age

• Autor(a) principal: Fabião, J.
• Data de Publicação: 2022
• Outros Autores: Sassi, B., Pedrollo, Elis Forcellini, Gerchman, Fernando, Kramer, Caroline Kaercher, Leitão, Cristiane Bauermann, Pinto, Lana Catani Ferreira
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/240304
• topic: COVID-19; Hormônios esteróides gonadais; Metanálise; Sexual hormone; Meta-analysis

We aimed to study the mechanism behind worse coronavirus disease-19 (COVID-19) outcomes in men and whether the differences between sexes regarding mortality as well as disease severity are influenced by sex hormones. To do so, we used age as a covariate in the meta-regression and subgroup analyses. This was a systematic search and meta-analysis of observational cohorts reporting COVID-19 outcomes. The PubMed (Medline) and Cochrane Library databases were searched. The primary outcome was COVID-19-associated mortality and the secondary outcome was COVID-19 severity. The study was registered at PROSPERO: 42020182924. For mortality, men had a relative risk of 1.36 (95%CI: 1.17 to 1.59; I² 63%, P for heterogeneity <0.01) compared to women. Age was not a significant covariate in meta-analysis heterogeneity (P=0.393) or subgroup analysis. For disease severity, being male was associated with a relative risk of 1.29 (95%CI: 1.19 to 1.40; I² 48%, P for heterogeneity <0.01) compared to the relative risk of women. Again, age did not influence the outcomes of the metaregression (P=0.914) or subgroup analysis. Men had a higher risk of COVID-19 mortality and severity regardless of age, decreasing the odds of hormonal influences in the described outcomes.