Females in India at Higher Risk of Death from Coronavirus Than Males, Shows Study

According to a study, females in India bear a higher relative-risk of death from the novel coronavirus disease than males.

Even though males overall bear a higher burden of coronavirus, In India, women have a higher Covid-19 case fatality rate (CFR) - which is the ratio of confirmed deaths in total confirmed cases, states a report by the Indian Express, citing a study.

The study - "Equal risk, unequal burden? Gender differentials in COVID-19 mortality in India", published in the Journal of Global Health Science analysed data till May 20 to show that the overall case fatality rate among females in 3.3%, much higher than that of males, which is 2.9%.

The findings call for greater attention towards females in coronavirus treatment.

The researchers used crowdsourced data (https://www.covid19india.org/) to provide preliminary estimates for age-sex specific Covid-19 CFR for India. They analysed the burden of the cases and deaths for age-sex categories.

These researchers are from a diverse and wide background - from the Population Research Centre, Institute of Economic Growth, Delhi, Institute of Health Management Research, IIHMR University, Jaipur, Centre for Development Studies, Thiruvananthapuram, Harvard Centre for Population and Development Studies, Cambridge, USA and Department of Social and Behavioral Sciences, and Harvard T H Chan School of Public Health, Boston.

The study shows that males share a higher burden (66%) of Covid-19 infections than females (34%) but the infection is more or less evenly distributed in under-five as well as elderly age groups.The CFR among males and females is 2.9% and 3.3%, respectively.

The WHO world standard population structure standardized CFR for India is 3.34 per cent. The adjusted-CFR is estimated to be 4.8 per cent.

The study says that elderly males and females both display high mortality risk and require special care when infected. It calls for greater focus on data collection and sharing of age-sex specific COVID-19 cases and mortality data to develop robust estimates of COVID-19 case fatality to support policy decisions.

The study points out that while early estimates from the Ministry of Health and Family Welfare in India indicate that three-fourth of all confirmed cases are males, it is important to disaggregate the burden to understand whether the inference is valid for children as well as the elderly age group. Researchers said the bulk of the evidence on age-sex patterns in COVID-19 mortality has focused on adults and the elderly, but very little is known about the age-sex specific relative risks and patterns of COVID-19 mortality, particularly for populous and resource-poor settings such as India.

"An important concern here is to examine the overall as well as age-specific COVID-19 infection and mortality risk from a gender lens. Preliminary evidence from various countries suggests that men are at greater risk of both infections and deaths, but these inferences should be carefully interpreted," the study said.

The study data states that till May 20, females overall had 34.3 per cent share in total burden of Covid-19 cases.

Overall, females have 34.3% share in total burden of COVID-19 infections and the burden is more or less similar among under-five boys (51.5%) and girls (48.5%), according to the study. The burden increases among males in middle age group and reaches a maximum of 70.4% for the age group 30–39 years. "Thereafter, the share of females in total burden increases with age. The burden among females is over 40% for the age groups 70–79 years and 80+ years," the study states.

According to the study, he burden of females in total COVID-19 deaths is 36.9%. The absolute burden of deaths among females is higher than males than the absolute burden among females in total number of infections. The difference in female burden in infections and deaths is 2.6%, it shows.

Females in the age group 30–39 years have lowest burden of death (21.3%) whereas elderly females in the age group 80+ years have more or similar burden (48.5%) in total death for this particular age group. Although, females share a lower mortality burden than males in general but there is no reported case of male mortality in the age group 5–19 years hence the entire burden is borne by females, the study reports.

As per the data till May 20, 2020, Children and adolescents (below age 20 years) account for 13.8% share in total COVID-19 infections but have relatively lower burden of 2.1% in total COVID-19 deaths.

Elderly aged (60 and above) although account for 9.7% share in total infection but they account for 51.6% share in total deaths. The age-specific relative burden in deaths among males aged 60 years is 50.7% whereas the same is 54.5% among females. The population in the age group 20–59 years have a higher relative burden of 76.4% in total cases but account for 46.4% share in total deaths. The relative burden of total cases is higher among the middle-aged population but the relative burden in deaths is mostly borne by the elderly population.