Role of Sex and Age in Fatal Outcomes of COVID-19: Women and Older Centenarians Are More Resilient

In the present paper, we have analysed the role of age and sex in the fatal outcome of COVID-19, as there are conflicting results in the literature. As such, we have answered three controversial questions regarding this aspect of the COVID-19 pandemic: (1) Have women been more resilient than men? (2) Did centenarians die less than the remaining older people? (3) Were older centenarians more resistant to SARS-CoV-2 than younger centenarians? The literature review demonstrated that: (1) it is women who are more resilient, in agreement with data showing that women live longer than men even during severe famines and epidemics; however, there are conflicting data regarding centenarian men; (2) centenarians overall did not die less than remaining older people, likely linked to their frailty; (3) in the first pandemic wave of 2020, centenarians > 101 years old (i.e., born before 1919), but not younger centenarians, have been more resilient to COVID-19 and this may be related to the 1918 Spanish flu epidemic, although it is unclear what the mechanisms might be involved.

Automated summary

In this paper, the role of age and sex in the fatal outcome of COVID-19 was analyzed, and conflicting results in the literature were discussed. The findings showed that women are more resilient than men, centenarians overall did not have lower mortality rates compared to other older individuals, and centenarians over the age of 101 showed greater resilience to COVID-19 compared to younger centenarians in the first wave of the pandemic in 2020. The potential relationship with the 1918 Spanish flu epidemic is still unclear, and further research is needed to understand the underlying mechanisms.