Are men and obese people really at greater risk of dying from COVID-19?

A reanalysis of 58 existing studies suggests that with COVID-19 being male or seriously overweight isn’t as risky as originally thought.

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Throughout the pandemic, we’ve heard that men and obese people have a greater risk of developing serious illness or dying if they become infected with SARS-CoV-2. However, a new study led by Professor Bruce Biccard at the University of Cape Town, in South Africa, and published in Anaesthesia suggests that, when it comes to those who are admitted into intensive care (ICU), being male and/or severely overweight does not mean you’re at greater risk of dying from COVID-19.

The analysis, which combined the results of 58 previously published studies involving 44,305 patients, doesn’t necessarily mean these factors aren’t associated with a greater risk of developing severe disease.

Biccard said: “What is interesting, is that there are more male patients than female patients in the intensive care unit (ICU) cohort. It raises all sorts of questions; do more men get severe disease, or do men receive preferential treatment compared to women, i.e., greater access to care if they develop severe disease? Gender inequality in care needs to be considered.”

He added that although obesity appears to be relatively protective for patients suffering from other illnesses who are admitted to ICU – a phenomenon known as the "obesity paradox” – this does not appear to be the case for those with COVID-19.

The study also identified a number of factors that are associated with a greater risk of death for ICU patients with COVID-19: a history of smoking; high blood pressure; diabetes; respiratory, cardiovascular or kidney disease; and cancer. Patients who required mechanical ventilation to help them breathe, had elevated white blood cell counts and other markers of inflammation, or who had severe organ failure, also faced at greater risk of dying, compared to other patients.