Sex-Differences in COVID-19 Diagnosis, Risk Factors and Disease Comorbidities

Introduction: Morbidity and mortality from COVID-19 are greater for males, however, the mechanisms for this difference are unclear. We aim to investigate sex-gender differences in COVID-19 in a large US-based cohort, namely COVID-19 Research Database. Specifically, the objectives of the present study are to explore the socio-economic characteristics of COVID-19 male and female patients and to examine potential sex differences in lifestyle factors and disease comorbidities among diagnosed patients. Methods: This is a retrospective cohort study comparing males versus females with test-confirmed COVID-19 between January 2020 and December 2021 (N=62,310). The study used secondary data, called Healthjump, which were extracted from patients’ medical claims and electronic health records (e.g., demographics, encounters, medical history, procedures, social history, and vitals). Results: Significant socio-demographic and comorbidity differences were observed between male and female patients (p<0.05). For example, a significantly higher proportion of males (vs. females) were aged ≥70-year-old (17.04% vs. 15.01%) and smokers (11.04 %vs. 9.24%, p<0.0001). In addition, multiple logistic regression showed that hypertension and diabetes were significantly more frequent in males (AOR=66.19 and AOR=22.90). Conclusions: Understanding the differences in outcomes between males and females will inform gender equity responsive policy approaches to COVID-19 and improve the effectiveness of health interventions.