COVID-19 mortality: A complex interplay of sex, gender, and ethnicity.

Several studies have reported a higher rate of COVID-19 mortality in men.1–3 A higher rate of COVID-19 mortality has also been reported in Black, Asian and minority ethnic (BAME) groups,3–5 especially among healthcare providers.6

The exact reasons for these disparities are not known but may be due to differential susceptibility based on biological sex,7 as well as gender differences in health behaviours (e.g. smoking) giving rise to differences in comorbidities (e.g. cardiovascular disease) that increase the risk of COVID-19 mortality in men.8 However, there are social influences that could influence gender differences in exposure and infection; e.g., women are more likely to be involved in service sector work/healthcare; men are more involved in other high-risk jobs such as drivers.3,8 In regards to ethnic differences, people from BAME background may be more likely to be in the frontline, exposed, jobs; they may be more likely to live in crowded multi-generation households making it challenging to maintain physical distancing from elderly family members. [Taken from introduction]