The Gender Disparity in COVID-19 Case Severity


  • Shaun Lau Henry M. Gunn High School
  • Elana Zizmor Henry M. Gunn High School



COVID-19, Gender, Discrepancy


SARS-CoV-2 has made the world come to a halt, causing unprecedented global protocols and rules being implemented. Many different characteristics of this virus emerged early on. A notable characteristic that was noticed was the disparity in COVID-19 severity between the two biological genders, with males having a significantly higher fatality rate in comparison to females. As studies continue to understand this disparity, this literature review intends to summarize a few of these findings. Research on these studies were found on public research engines like ScienceDirect, Biology Medcentral, and PubMed. Papers were all peer reviewed. Another tool that was used was from the Global Health 50/50 research initiative which provided sex dis-aggregated data on COVID-19 in all countries that had accessible data. Studies have indicated that genetic factors, lifestyle factors, and “other” factors are all reasons for the disparity. T-Cell and ACE2 protein amount difference in males and females have been suggested as possible reasons for the discrepancy. Studies have also suggested that increased COVID-19 viral load also increases infection severity. This is relevant as male attitudes towards COVID-19 public health guidelines are more relaxed compared to females. Other possible factors that could play into this disparity is smoking, with active smokers having increased COVID-19 infection severity. This relates to the fact that the percent of male smokers is much higher than females. These lifestyle factors are further supported by the fact that males have higher fatality rates in respiratory tract diseases including SARS and influenza.


Download data is not yet available.

References or Bibliography

Asirvatham, E., Sarman, C., Saravanamurthy, S., Mahalingam, P., Maduraipandian, S., & Lakshmanan, J. (2020, October 03). Who is dying from COVID-19 and when? An Analysis of fatalities in Tamil Nadu, India. Retrieved January 23, 2021, from

COVID-19 Sex-Disaggregated Data Tracker. (2020). Retrieved January 23, 2021, from

Takahashi, T., Ellingson, M., Wong, P., Israelow, B., Lucas, C., Klein, J., . . . Iwasaki, A. (2020, August 26). Sex differences in immune responses that underlie COVID-19 disease outcomes. Retrieved January 23, 2021, from

Culley, F., Pennycook, A., Tregoning, J., Dodd, J., Walzl, G., Wells, T., . . . Openshaw, P. (2006, August 15). Role of CCL5 (RANTES) in Viral Lung Disease. Retrieved January 28, 2021, from

Yang, J., Petitjean, S., Koehler, M., Zhang, Q., Dumitru, A., Chen, W., . . . Alsteens, D. (2020, September 11). Molecular interaction and inhibition of SARS-CoV-2 binding to the ACE2 receptor. Retrieved January 23, 2021, from

Hamming, I., Timens, W., Bulthuis, M., Lely, A., Navis, G., & Van Goor, H. (2004, June). Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. Retrieved January 25, 2021, from

Gheblawi, M., Wang, K., Viveiros, A., Nguyen, Q., Zhong, J., Turner, A., . . . Oudit, G. (2020, May 8). Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System: Celebrating the 20th Anniversary of the Discovery of ACE2. Retrieved January 23, 2021, from

Viveiros, A., Rasmuson, J., Vu, J., Mulvagh, S. L., Yip, C. Y., Norris, C. M., & Oudit, G. Y. (2020, December 4t). Sex differences in COVID-19: Candidate pathways, genetics of ACE2, and sex hormones. Retrieved January 7th, 2021, from

Benigni, A., Cassis, P., & Remuzzi, G. (2010, July). Angiotensin II revisited: New roles in inflammation, immunology and aging. Retrieved January 23, 2021, from

McLachlan, C. (2020, July 15). The angiotensin-converting enzyme 2 (ACE2) receptor in the prevention and treatment of COVID-19 are distinctly different paradigms. Retrieved January 23, 2021, from

Ni, W., Yang, X., Yang, D., Bao, J., Li, R., Xiao, Y., . . . Gao, Z. (2020, July 13). Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Retrieved January 5, 2021, from

Gagliardi, M., Tieri, P., Ortona, E., & Ruggieri, A. (2020, May 26). ACE2 expression and sex disparity in COVID-19. Retrieved January 23, 2021, from

Karlberg, J., Chong, D., & Lai, W. (2004, February 01). Do Men Have a Higher Case Fatality Rate of Severe Acute Respiratory Syndrome than Women Do? Retrieved January 23, 2021, from

Khan, S., El Morabet, R., Khan, R., Bindajam, A., Alqadhi, S., Alsubih, M., & Khan, N. (2020, December 10). Where we missed? Middle East Respiratory Syndrome (MERS-CoV) epidemiology in Saudi Arabia; 2012-2019. Retrieved January 23, 2021, from

Fajnzylber, J., Regan, J., Coxen, K., Corry, H., Wong, C., Rosenthal, A., . . . Li, J. (2020, October 30). SARS-CoV-2 viral load is associated with increased disease severity and mortality. Retrieved January 23, 2021, from

Cai, G., Bossé, Y., Xiao, F., Kheradmand, F., & Amos, C. (2020, June 15). Tobacco Smoking Increases the Lung Gene Expression of ACE2, the Receptor of SARS-CoV-2. Retrieved January 23, 2021, from

Lippi, G., & Henry, B. (2020, May). Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). Retrieved January 23, 2021, from

Gülsen, A., Yigitbas, B., Uslu, B., Drömann, D., & Kilinc, O. (2020, September 8). The Effect of Smoking on COVID-19 Symptom Severity: Systematic Review and Meta-Analysis. Retrieved January 23, 2021, from

Pampel, F. (2006, December). Global Patterns and Determinants of Sex Differences in Smoking. Retrieved January 23, 2021, from

Galasso, V., Pons, V., & Profeta, P. (2020, November 7). Gender differences in COVID-19 perception and compliance. Retrieved January 23, 2021, from

Centers for Disease Control and Prevention. (2019) Current Cigarette Smoking Among Adults in the United States. Retrieved January 23 2021, from

World Health Organization (2010) World Health Organization, from

(2005)Kung, H., Hoyert, D. L., Xu, J., & Murphy, S. L. (2005). Deaths: Final Data for 2005 (Vol. 56, pp. 5-6, Rep. No. 10). CDC.

(2010) Murphy, S. L., Xu, J., & Kochanek, K. D. (2013). Deaths: Final Data for 2010 (Vol. 61, pp. 5-6, Rep. No. 4). CDC.

(2015) Murphy, S. L., Xu, J., Kochanek, K. D., Curtin, S. C., & Arias, E. (2017). Deaths: Final Data for 2015 (Vol. 66, pp. 5-6, Rep. No. 6). CDC.



How to Cite

Lau, S., & Zizmor, E. (2021). The Gender Disparity in COVID-19 Case Severity. Journal of Student Research, 10(2).



HS Review Articles