There are many reasons why male mortality rates are higher than female and the range is broad — from soaring cigarette and alcohol consumption among men to superior immune systems among women, backed by estrogen, a feminine hormone.
In old times, men represented a symbol of physical strength and endurance. That's no longer the case since women have proved equally efficient in every field. Now with the devastating reach of coronavirus across the world, killing nearly 40,000 people, the old notion of male superiority is once again falling apart at the seams as data show men have succumbed to the virus more than women.
Troves of data collected from different countries suggest men are twice as likely as women to die from the virus almost in countries like Italy and China.
In Italy, a staggering 70 percent of deaths from the virus have been men, while men made up 64 percent of deaths in China. In all other countries that have made their data available for scientists to analyse, male patients have been killed by the virus more than female virus carriers.
"When we look at the data what we're seeing is that in every country with sex-disaggregated data ... there is between a 10 percent and 90 percent higher rate of mortality amongst people diagnosed with Covid if they are men compared to if they are women," said Sarah Hawkes, professor of global public health at University College London (UCL), who is also a co-director at Global Health 50/50, which has analysed Covid-19 mortality deaths by sex across the world.
Scientists hold unhealthy lifestyles and addictions such as smoking and drinking responsible for male susceptibility to the virus.
In most cases, the coronavirus has affected lungs, inflating them to the point that patients gasp for oxygen as they struggle to breathe, which in most cases leads to one or multiple organ failures, accelerating the chances of death. Since smokers and drinkers have less healthy lungs, their chances to fight off the virus with or without life support are less.
Worldwide data from 2015 have shown that men smoke and drink almost five times more than women, according to CNN.
In China, which has the largest number of smokers on earth, half of Chinese men smoke while only less than 3 percent of women smoke, according to the Chinese health authority.
In Italy, the smoking rate between men and women is three to two, the country’s National Health Institute has found this year.
Female immune system defeats virus
A large part of the scientific community has a consensus that women’s strong immunity system, which responds to viral infections much sooner and stronger, is directly related to oestrogen and female fertility.
“Every pregnancy makes the female body rejuvenate. In order to feed her baby, the female body produces various hormones in high levels. Those hormones also renew their tissues and cells. As a result, they have such a natural advantage [in terms of surviving],” Mehmet Yildirim, a general surgery specialist and a professor of medicine at the Bilecik University, told TRT World.
According to Human Genomics, a biology journal, women have two X chromosomes, which makes them capable of fighting back various diseases. The X chromosome is one of the two sex-determining chromosomes.
Other experts also agree that oestrogen protects women in different settings.
Perlman is one of the rare scientists who studied coronavirus infection in mice between 2016 and 2017, finding out that male mice are more susceptible to the virus than females.
The scientist also discovered that the mortality rate of female mice went up if their ovaries were taken out or their oestrogen activity was prevented.
As a result, beyond old age or smoking, the real reason behind the high mortality rate of men from Covid-19 might be a weak immune system that finds it hard to repel deadly viruses with the same efficiency as female bodies do.
"It might have to do with hormonal changes. There is actual research in animals that has shown there may be a biological basis for the sort of increasing susceptibility in the male gender and not only that but also an increased severity and response to the virus," said Luis Ostrosky-Zeichner, another infectious disease specialist at McGovern Medical School at UTHealth in Texas.
Scientists also thinkthat the female body’s initial strong reaction to the virus attack is one of the key determinators to fend off the infection. Experts say that if the first reaction fails to stop the virus, the latter responses of the immune system might create more problems than addressing the issue, increasing the levels of infection in the lungs.
“When [a] severe outcome is caused by an inability to rapidly control the infection, then it is often adult males who suffer worse outcomes than females,” Sabra Klein, a professor at Johns Hopkins’s Bloomberg School of Public Health, told the Washington Post.
Many experts think that the female immune system’s power could be a learning lesson for scientists to defeat viruses like the Covid-19.
But despite the age of information, data on gender differences is limited, which hampers the process of developing a comprehensive model comparing female-male mortality rates, according to experts.
While the World Health Organization has demanded countries report their gender-specific data since 2007, many countries including the US and the UK have failed to provide it, making it difficult to develop an in-depth understanding of why more men die than women,experts say.