Sex-specific differences in COVID-19 testing, cases and outcomes: a population-wide study in Ontario, Canada

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in Wuhan,
China in late 2019 and spread globally resulting in the COVID-19 pandemic.1 During the two
previous coronavirus epidemics, Severe Acute Respiratory Syndrome (SARS) and Middle East
Respiratory Syndrome (MERS), male sex was associated with worse clinical outcomes.2 Though
there is limited sex-disaggregated COVID-19 incidence and outcome data, reports from
epidemics in Italy and China indicate that men may also be more affected.1,3 It is unclear whether
these findings may be skewed because of unreported sex-based differences in SARS-CoV-2
testing and the age distributions of study populations