Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 20:10:20503121221105583.
doi: 10.1177/20503121221105583. eCollection 2022.

Male sex rather than socioeconomic vulnerability as a determinant for COVID-19 death in Sao Paulo: A population-based study

Jorge Hallak  1   2 , Thiago A Teixeira  1   2 , Ligia V Barrozo  2   3 , Júlio Singer  2   4 , Esper G Kallas  5 , Paulo Hn Saldiva  2   6
Affiliations

Male sex rather than socioeconomic vulnerability as a determinant for COVID-19 death in Sao Paulo: A population-based study

Jorge Hallak et al. SAGE Open Med. .

Abstract

Objectives: To determine the role of the male sex as a risk factor for coronavirus disease deaths in Sao Paulo and to what extent socioeconomic vulnerability and individual health issues can interfere in such risk.

Methods: The primary cause of death, age, sex, comorbidities, and code of the Human Development Units of the residence of 37,583 individuals in Sao Paulo, Brazil, were obtained from the records on confirmed coronavirus disease resident hospitalizations of the city of Sao Paulo from the National Influenza Surveillance Information System. A social vulnerability index was assigned to each Human Development Unit. Using "death" as the outcome variable and sex, admission to the intensive care unit, obesity, renal and heart diseases, diabetes, and social vulnerability as confounders, the odds of death for males and females were compared via logistic regression.

Results: The odds of death for males were 1.242 (confidence interval 95% = 1.237, 1.247) times the corresponding odds for females with the same values for all confounders. We estimated the odds of death for patients living in regions with high social vulnerability as 2.243 (CI 95% = 2.151, 2.339) times the corresponding odds of patients living in regions with very low social vulnerability with the same values of the remaining variables.

Conclusion: The male:female death ratio by severe acute respiratory syndrome coronavirus 2 infection in Sao Paulo cannot be attributed only to comorbidities or social vulnerabilities. Our results suggest that the male sex is an independent biological risk factor for coronavirus disease death. Besides sex-specific factors, further research should focus on crucial biological factors in male sex coronavirus disease mortality.

Keywords: coronavirus disease; male sex; men’s health; mortality; severe acute respiratory syndrome coronavirus 2.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Registers of hospitalizations, residents, City of São Paulo, Brazil; data source: Epidemiology and Information Coordination Center (CEInfo), São Paulo Health Secretariat (SMS-SP). State of São Paulo Electronic Information System (e-SIC database, protocol 50161).
Figure 2.
Figure 2.
Male: female ratio of deaths of reported COVID-19 cases, City of São Paulo, Brazil, by Human Development Unit; data source: Mortality Information Improvement Program (PRO-AIM), Epidemiology and Information Coordination Center (CEInfo), São Paulo Health Secretariat (SMS-SP). Data obtained through a formal request to the São Paulo Electronic Information System (e-SIC database, protocol 50161).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Petrilli CM, Jones SA, Yang J, et al.. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ 2020; 369: m1966. - PMC - PubMed
    1. Richardson S, Hirsch JS, Narasimhan M, et al.. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA 2020; 323: 2052–2059. - PMC - PubMed
    1. Chanana N, Palmo T, Sharma K, et al.. Sex-derived attributes contributing to SARS-CoV-2 mortality. Am J Physiol Endocrinol Metab 2020; 319: E562–E567. - PMC - PubMed
    1. O’Hearn M, Liu J, Cudhea F, et al.. Coronavirus disease 2019 hospitalizations attributable to cardiometabolic conditions in the United States: a comparative risk assessment analysis. J Am Heart Assoc 2021; 10: e019259. - PMC - PubMed
    1. The Lancet. Gender and health are also about boys and men. Lancet 2018; 392: 188. - PubMed

LinkOut - more resources