Abate BB, Kassie AM, Kassaw MW, Aragie TG, Masresha SA. Sex difference in coronavirus disease (COVID-19): a systematic review and meta-analysis.
BMJ Open 2020;
10:e040129. [PMID:
33028563 PMCID:
PMC7539579 DOI:
10.1136/bmjopen-2020-040129]
[Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE
To assess the sex difference in the prevalence of COVID-19 confirmed cases.
DESIGN
Systematic review and meta-analysis.
SETTING
PubMed, Cochrane Library and Google Scholar were searched for related information. The authors developed a data extraction form on an Excel sheet and the following data from eligible studies were extracted: author, country, sample size, number of female patients and number of male patients. Using STATA V.14 for analysis, the authors pooled the overall prevalence of men and/or women using a random-effect meta-analysis model. The authors examined the heterogeneity in effect size using Q statistics and I2 statistics. Subgroup and sensitivity analyses were performed. Publication bias was also checked.
PARTICIPANTS
Studies on COVID-19 confirmed cases were included.
INTERVENTION
Sex (male/female) of COVID-19 confirmed cases was considered.
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary outcome was prevalence of COVID-19 among men and women.
RESULTS
A total of 57 studies with 221 195 participants were used in the analysis. The pooled prevalence of COVID-19 among men was found to be 55.00 (51.43-56.58, I2=99.5%, p<0.001). Sensitivity analysis showed the findings were not dependent on a single study. Moreover, a funnel plot showed symmetrical distribution. Egger's regression test p value was not significant, which indicates absence of publication bias in both outcomes.
CONCLUSIONS
The prevalence of symptomatic COVID-19 was found to be higher in men than in women. The high prevalence of smoking and alcohol consumption contributed to the high prevalence of COVID-19 among men. Additional studies on the discrepancies in severity and mortality rate due to COVID-19 among men and women and the associated factors are recommended.
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