Gender differences in death rates due to the covid-19 pandemic in italy

Italy was the first European country hit by the COVID-19 pandemic. As of March 3, 2021, the Italian national surveillance system had registered 2,953,120 cases and 96,977 deaths, with gender differences both in terms of cases and deaths. Therefore, the aim of this observational ecological study is to analyze gender differences during the first year of COVID-19 pandemic in Italy in terms of crude mortality rate (CMR) and case fatality rate (CFR). We collected data from the official database of the Italian National Institute of Health (Istituto Superiore di Sanità – ISS). We considered the two waves of the pandemic, using the date between the two peaks that had the trough (lowest number of deaths) for a 7-day average to separate the two periods). Then, we calculated the CMR and CFR by age group for males and females, considering three periods: overall, first wave and second wave. Our study shows that male gender reported both higher CMR and CFR than female, and this data is confirmed for all the age group. Although many demographic, socioeconom-ic, hormonal, genetic, and epigenetic factors may explain these differences, further studies are required in order to understand the pathophysiological mechanisms underlying gender differences in CMR and CFR due to COVID-19.