Morbidity, mortality and sex-specific impacts of COVID-19

31 August 2020

This rapid research brief synthesises the evidence on determinants of morbidity and mortality due to COVID-19, and sex-related differences.

Key findings:

  • There is little evidence that biological differences, including age, sex and comorbidity, influence the risk of acquiring the infection.
  • Age is the leading determinant of severe disease and death among people with COVID-19. The risk associated with age increases rapidly from the age of 40 years.
  • Compared to females, males with COVID-19 are more likely to be hospitalised, more likely to be admitted to an ICU and more likely to die.
  • Among people with COVID-19, many medical comorbidities, such as heart disease and chronic obstructive pulmonary disease, increase the risk of hospitalisation, ICU admission and death. However, some comorbidities, such as asthma, probably do not increase risks.
  • Low socio-economic status increases both the risk of acquiring COVID-19 and the risk of developing severe disease once infected. Risk of severe disease once infected is probably mainly due to the prevalence of comorbidities that are associated with low socio-economic status.
  • The data on prolonged morbidity of COVID-19 among survivors are not yet available. Therefore, the factors that predict a higher risk of prolonged morbidity, and the nature of these long-term effects, remain to be defined.

Contributing authors
Lead author: Professor Michael Reade AM
Lead author: Professor Michael Reade AM Professor of Military Surgery and Medicine, University of Queensland and Australian Defence Force Joint Health Command
Dr Carinna Hockham
Dr Carinna Hockham Research Fellow, The George Institute for Global Health
Professor Fran Baum AO FASSA FAHM
Professor Fran Baum AO FASSA FAHM Matthew Flinders Distinguished Professor, Southgate Institute for Health, Flinders University
Emeritus Professor Jennifer Graves AO FAA
Emeritus Professor Jennifer Graves AO FAA La Trobe University
Dr Kirsty Short
Dr Kirsty Short Australian Research Fellow, Faculty of Science, University of Queensland
Dr Michael Maze FRACP
Dr Michael Maze FRACP Senior Lecturer in Medicine, Respiratory Physician, University of Otago
Professor Robyn Norton AO FAHMS
Professor Robyn Norton AO FAHMS Principal Director, The George Institute for Global Health Professor of Public Health, Faculty of Medicine, UNSW Sydney
Peer reviewers
Professor Don Nutbeam FAHMS
Professor Don Nutbeam FAHMS Professor of Public Health University of Sydney
Professor Katherine Kedzierska FAHMS
Professor Katherine Kedzierska FAHMS NHMRC Leadership Fellow and Dame Kate Campbell Fellow, The Peter Doherty Institute for Infection and Immunity, University of Melbourne
Professor Lisa Cameron
Professor Lisa Cameron Professorial Research Fellow, Melbourne Institute of Applied Economic and Social Research, University of Melbourne
Professor Mark Woodward
Professor Mark Woodward Professor of Medical Statistics, The George Institute for Global Health, UNSW Sydney
Dr Margarita Moreno-Betancur
Dr Margarita Moreno-Betancur ARC DECRA Fellow, Clinical Epidemiology and Biostatistics Unit, University of Melbourne and Murdoch Children’s Research Institute
Dr Sonya Bennett
Dr Sonya Bennett Chair, Communicable Diseases Network Australia and Deputy Chief Health Officer, Queensland Health

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