BERKELEY, Calif. - New questions are emerging as the coronavirus continues to take lives and data in multiple parts of the world show that men with COVID-19 have a higher fatality rate than women.
In the San Francisco Bay Area, Santa Clara County reported 1,224 confirmed cases Monday with a gender breakdown of 52% men and 48% women. The gender of those who died from COVID-19, however, show 67% of the deaths in the county are men.
A preliminary study from China also shows more male than female patients dying from COVID-19 and a World Health Organization Chart for Italy and Spain has a higher rate of death for men from COVID-19.
"There are several factors that contribute to this gender difference," said Dr. Lee Riley, a University of California at Berkeley professor and head of the division of Infectious Disease and Vaccinology at the school of Public Health.
Behavior could be one big factor, with men tending to smoke and drink alcohol more than women.
"That can contribute to different type of cardiovascular diseases and cardiovascular diseases themselves are also associated with bad outcomes in coronavirus infection," Riley said.
Santa Clara County statistics for 2014 show the ratio of smoking rates for men and women in the county are similar to the coronavirus fatality ratio.
Riley said studies show men also tend to wait longer than women to visit doctors.
"So by the time they get to a doctor, they may have more severe disease," said Dr. Riley.
Riley said there is research that indicates genetics might give women's immune systems an advantage, with two X chromosomes.
"In the X chromosome there are a couple genes that are involved in the immune response whereas the males there's only one," he said.
Researchers say COVID-19 is not the only respiratory disease that shows a gender difference.
"The SARS epidemic we saw 17 years ago, again, there was a male predominance in deaths," Riley said. "Tuberculosis is another major respiratory infectious disease and we see a ratio of 70 to 30, the disease being much more common in males."
Riley said as researchers look for vaccines and cures, it is important to collect and analyze data for gender and also analyze differences in race and ethnicity.
"This particular coronavirus infection is greater among African Americans and people of ethnic minority backgrounds so those type of data are very important," Riley said.
In Illinois, health officials say African Americans account for 30% of all coronavirus cases and in Chicago, nearly 70% of the deaths are among African Americans. Mayor Lori Lightfoot says the numbers highlight a longstanding disparity in health care access that needs to be addressed. Many of the victims have other underlying health conditions.
Lousiana Governor John Bel Edwards announced that about 70% of the deaths in his state are African Americans and mentioned that hypertension was one of the factors in the deaths.
On Monday, the Lawyers Committee for Civil Rights Under Law sent a letter to Health and Human Services Secretary Alex Azar. The letter calls for the government to release more data to the public on the race and ethnicity of people with COVID-19.
Jana Katsuyama is a reporter forKTVU. Email Jana at firstname.lastname@example.org and follow her on Twitter@JanaKTVU