2022
DOI: 10.1590/1414-431x2021e11711
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Why do men have worse COVID-19-related outcomes? A systematic review and meta-analysis with sex adjusted for age

Abstract: 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 mor… Show more

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Cited by 41 publications
(43 citation statements)
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“…11,30 The reasons include a reduced willingness to participate in clinical trials, differences in prognosis, perceived symptoms, and perceived greater risk of harm from interventions. [31][32][33][34][35][36][37] In addition, pregnant women have routinely been excluded from clinical trials, 38 and women of reproductive age have more concerns about the safety and efficacy of the treatments for themselves and their babies. 30,39 Furthermore, evidence has shown that women were more adversely affected by the COVID-19 pandemic, including with respect to access to clinical trials and routine health care, 15,40,41 potentially reflecting higher employment loss or increased household responsibilities and childcare.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…11,30 The reasons include a reduced willingness to participate in clinical trials, differences in prognosis, perceived symptoms, and perceived greater risk of harm from interventions. [31][32][33][34][35][36][37] In addition, pregnant women have routinely been excluded from clinical trials, 38 and women of reproductive age have more concerns about the safety and efficacy of the treatments for themselves and their babies. 30,39 Furthermore, evidence has shown that women were more adversely affected by the COVID-19 pandemic, including with respect to access to clinical trials and routine health care, 15,40,41 potentially reflecting higher employment loss or increased household responsibilities and childcare.…”
Section: Discussionmentioning
confidence: 99%
“…Female participants have historically been underrepresented in clinical trials . The reasons include a reduced willingness to participate in clinical trials, differences in prognosis, perceived symptoms, and perceived greater risk of harm from interventions . In addition, pregnant women have routinely been excluded from clinical trials, and women of reproductive age have more concerns about the safety and efficacy of the treatments for themselves and their babies .…”
Section: Discussionmentioning
confidence: 99%
“…Tingginya angka kejadian COVID-19 pada laki-laki dikaitkan dengan adanya ekspresi ACE2 yang lebih tinggi dibandingkan dengan perempuan, serta efek hormonal diantaranya estrogen pada perempuan yang memiliki efek inhibisi terhadap ACE2.11 Hasil ini diperkuat dengan penelitian oleh Bertrand Cario di Prancis pada tahun 2021 yang menyatakan bahwa karakteristik responden berdasarkan jenis kelamin paling banyak berjenis kelamin laki-laki sebanyak 855 pasien dari 1317 pasien yang diteliti (64%).12 Diperkuat juga penelitian dari Jacqueline pada tahun 2020 di Amerika Serikat diketahui frekuensi tertinggi adalah laki-laki sebanyak 110 pasien dari 178 pasien yang diteliti (61,7%). 13 Berdasarkan penelitian yang telah dilakukan dengan mengabil 171 data rekam medis di RS Al-Islam Bandung yang memenuhi kriteria, didapatkan hasil yaitu pasien dengan hasil PCR positif sebanyak 85 orang dengan hasil pemeriksaan gula darah sewatku didapatkan 44 (58,7%) pasien COVID-19 mengalami hiperglikemi dan 41 (48,2%) pasien COVID-19 tidak mengalami hiperglikemia. Kejadian hiperglikemia pada pasien COVID-19 pada penelitian ini hampir sama dengan kejadian tidak hiperglikemia, kemungkinan hal ini dikarenakan adanya faktor usia, pemakaian obat-obatan anti-inflamasi steroid dan derajat keparahan.…”
Section: Cunclassified
“…Secondly, the subgroup analysis between gender indicated that male health workers were more likely than females to receive COVID-19 vaccines [41][42][43][44][45][46][47][48]. The likely reason was that COVID-19 severity and mortality were increased in male compared to female [49]. It may also be related to women's special conditions, such as menstruation, pregnancy and lactation, which affect women's willingness to get vaccinated against COVID-19.…”
Section: Plos Onementioning
confidence: 99%