A new study in the International Journal of Infectious Diseases analyzed World Health Organization (WHO) data and found COVID-19 increased existing gender mortality gaps in high-income countries until 2021, when COVID-19 vaccines were rolled out.
The findings are based on excess mortality estimates for 75 countries in 2020 and 62 countries in 2021. Middle-income countries did not see the same gender mortality gap issues during the first years of the pandemic.
After age 45, men die at higher rates in nearly all places and at all ages, the authors wrote. While previous studies have shown men die at higher rates than women from COVID-19, the excess mortality gap has not yet been fully described based on the economic status of countries.
The authors compared deaths in 2020 and 2021 to expected all-cause deaths using historic country-level monthly mortality data prior to the pandemic. Only countries with age- and sex-specific information were included in the final analysis.
Curve flat in middle-income countries
They found that high-income countries saw the most significant increase in gender mortality gaps, but the curve remained relatively flat in middle- and low-income countries.
Overall, in 2020, the average ratio of male-to-female mortality was higher for excess deaths (2.21) than for expected all-cause deaths (1.69), the authors found.
"COVID-19 amplified the gender mortality gap, at least at the age point of 65, in 2020. By 2021, the sex-ratio of excess deaths has fallen (to 1.84) but is still above the sex ratio for expected all-cause mortality in 2020 (1.69)," they wrote.
COVID-19 amplified the gender mortality gap, at least at the age point of 65, in 2020.
But by 2021, country income levels of countries had significant variations in mortality, largely due to the COVID vaccine rollout in wealthy nations, including European countries and the United States.
"This short-lived pattern suggests that COVID-19 may not have long-lasting implications for the gender gap in mortality in high-income countries, as was observed with the 1918 influenza epidemic (where a selection effect resulted in a decrease in the gender gap in mortality in years following that epidemic)," the researchers wrote.
