Men are more likely than women to die due to coronavirus disease 2019 (COVID-19). An open question is whether these sex differences reflect men’s generally poorer health and lower life expectancy compared to women of similar ages or if men face a unique COVID-19 disadvantage. Using age-specific data on COVID-19 mortality as well as cause-specific and all-cause mortality for 63 countries, we compared the sex difference in COVID-19 mortality to sex differences in all-cause mortality and mortality from other common causes of death to determine the magnitude of the excess male mortality disadvantage for COVID-19. We found that sex differences in the age-standardized COVID-19 mortality rate were substantially larger than for the age-standardized all-cause mortality rate and mortality rate for most other common causes of death. The excess male mortality disadvantage for COVID-19 was especially large in the oldest age groups. Our findings suggest that the causal pathways that link male sex to a higher mortality from a SARS-CoV-2 infection may be specific to SARS-CoV-2, rather than shared with the pathways responsible for the shorter life expectancy among men or sex differences for other common causes of death. Understanding these causal chains could assist in the development of therapeutics and preventive measures for COVID-19 and, possibly, other coronavirus diseases.

男性比女性更有可能死于 2019 年冠状病毒病 (COVID-19)。一个悬而未决的问题是，这些性别差异是否反映了男性与同龄女性相比普遍较差的健康状况和较低的预期寿命，或者男性是否面临独特的 COVID-19 劣势。我们使用 63 个国家的 COVID-19 死亡率以及特定原因和全因死亡率的特定年龄数据，比较了 COVID-19 死亡率的性别差异与全因死亡率和其他常见原因造成的死亡率的性别差异。死亡来确定 COVID-19 的男性死亡率过高劣势的程度。我们发现，年龄标准化的 COVID-19 死亡率的性别差异远大于年龄标准化的全因死亡率和大多数其他常见死因的死亡率。COVID-19 导致男性死亡率过高的劣势在最年长的年龄组中尤为明显。我们的研究结果表明，将男性与 SARS-CoV-2 感染的较高死亡率联系起来的因果途径可能是 SARS-CoV-2 特有的，而不是与导致男性预期寿命缩短或性别差异的途径共有其他常见的死亡原因。了解这些因果链有助于开发针对 COVID-19 以及可能的其他冠状病毒疾病的治疗和预防措施。而不是与导致男性预期寿命缩短或其他常见死亡原因的性别差异的途径共享。了解这些因果链有助于开发针对 COVID-19 以及可能的其他冠状病毒疾病的治疗和预防措施。而不是与导致男性预期寿命缩短或其他常见死亡原因的性别差异的途径共享。了解这些因果链有助于开发针对 COVID-19 以及可能的其他冠状病毒疾病的治疗和预防措施。