A Look at the Demographics of COVID-19 Patients

On a sunny and warm Saturday afternoon on March 21, New York City's Central Park was packed with people -- jogging, biking, playing, having picnics, or just strolling. Central Park was one of the very few places where residents could take a breath of fresh air before the city's "New York State on Pause", a partial lockdown, which went into effect the following day. Social distancing was hardly observed because it was impossible to stay 6 feet apart in that relatively small area crowded with people. Most of the park goers were young, reflecting the city's younger age population. The statistics and the media have been repeatedly saying that COVID- 19 does not affect younger people by and large, and if they become ill, they have mild symptoms. So, they were out and about.

COVID-19 is a new phenomenon for which consistent data has still yet to converge. Based on the information coming from China, where the outbreak first started, from all 72,314 cases as of February 11, 87% were people between ages of 30 and 79, while teens and people in their 20's seemed to be largely unaffected. Only 8.1% of the cases were in their 20's; 1.2% were teens; and 0.9% were 9 or younger.

In Italy, which is Europe's epicenter of this pandemic, the older population seems to make up a greater portion of the cases. According to the Journal of the American Medical Association, 37% of cases are 70 and older, compared to 12% of cases in China. The number of deaths in Italy, proportional to the number of registered cases, is also the highest in the world - as of March 31 out of the 105,792 registered cases, 12,428 patients have died. The major factor in the high number of deaths in Italy is age - many of the fatalities are people in their 80's and 90's, an age group that is much more susceptible to serious complications.

Interestingly, in Russia, where the COVID-19 outbreak has accelerated only in the past 10 days, a different pattern seems to appear. According to the local authorities in Moscow, only 15% of the 1,014 confirmed cases are over the age of 65. 33% of the infected are between 18 and 34, and 46% are between 35 and 46 years old. Nearly 40% of the patients who need ventilators are under 40 years old. The average age of Moscow's population is 38, with children representing 13.3%, and the elderly above the age of 65 constituting 21.5% of the Muscovites. As it stands, over 67% of the all cases in Russia are in the capital region.

Another finding, which has been partially affecting people's social behavior, is that the COVID-19 fatality rate is much higher in men than in women. While gender disparity in the confirmed cases is not that large, and even in some countries such as France, South Korea, Portugal, skewed more towards women, the fatality rate in men seems to be consistently higher. Based on reports from 12 affected countries (Italy, China, Germany, Spain, Iran, Switzerland, South Korea, the Netherlands, France, Sweden, Portugal and Denmark) the number of deaths among males is invariably higher than among females. The largest gap in male/female mortality ratio is reported in Italy and Denmark with 71% male and 29% female fatalities. The lowest mortality ratio is recorded in South Korea with 54% male and 46% female deaths. In the United States, there is no official report yet; however, based on preliminary reporting, the death rate in men is 60%. While there is not a definite answer to why there is a difference in the gender gap fatalities, the initial research points out to smoking habits in men in China, where 50% of men and only 2% of women smoke. However, in Italy that gap is not as wide - 28% of men and 19% of women are smokers. Other studies suggest that men are less likely to follow public health advice and engage in riskier behavior; men are also less likely to have medical checkups, to wash their hands, and to proactively sustain their health. But behavioral factors may not be the only answers to the higher fatality rates in men. Previous studies link weaker antiviral response in men to hormones such as estrogen and also to genes that regulate the immune system. These genes appear to be more active in women than in men.

Local and state authorities as well as international organizations are still collecting and analyzing data. It is very preliminary to announce that one age group is spared from this outbreak, although it appears that the younger population between the age of 0-29 is the least affected. The skewness toward one gender is inconclusive. It is too soon to proclaim that COVID-19 affects many more men than women, although the higher fatality rate in men seems to be overwhelmingly prevalent across countries. One thing is certain -- no one is immune to this disease. Complications and fatalities occur for all ages and for both genders.