COVID-19 mortality and sex

I recently looked at the progression of Covid-19 mortality risk with age.  As with all-cause mortality, another risk factor for Covid-19 is biological sex.  In Italy males account for 68.5% of Covid-19 deaths (ISS, 2020), an over-representation repeated in other countries' covid-19 mortality statistics.  This is shown in Figure 1.

Figure 1. Log-odds ratio for mortality of confirmed cases of Covid-19 in Italy by age and sex.  Source: own calculations using data from ISS (2020).

Another way of looking at this is relative risk, as shown in Figure 2 (we exclude the rates below age 30 due to small numbers of deaths).

Figure 2. Ratio of male mortality rate to female for confirmed cases of Covid-19 in Italy by age.  Source: own calculations using data from ISS (2020).

The excess depicted in Figure 3 is not the first time that males have shown much heavier mortality in response to viral infection: the same was true in the Spanish Influenza pandemic a century ago.  Figure 2 also gives pause for younger males who are tempted to conclude from Figure 1 that their risk is low: in the age range 30–60 male mortality from Covid-19 is more than triple the rate for females.  The current health advice therefore applies to everyone regardless of age or sex: keep your distance and wash your hands.