We now know that Covid19 affects men and women differently — initial research shows men are twice as likely to die from a coronavirus-related illness than women are; and women mount a stronger immune response against Covid19 than men do. While research shows both men and women are equally likely to contract Covid19, the way the infection behaves in their bodies is markedly different, not just because of external habits, but internal genetic make-up.
Now, with this information, it’s only logical the scientific community’s study of the novel coronavirus takes a sex-based approach to understanding, diagnosing, and treating Covid19 — but unfortunately, a new pre-print study finds that’s not the case at all. Researchers evaluated 2,484 registered Covid19 trials and found only 16.7% (416) mention gender or sex as a recruitment criterion for study participants. It gets even worse at the analysis stage — only 4.1% of these trials mention deriving a sex-based understanding of their findings. Researchers also analyzed clinical trials published in the month of June 2020 — and found all 11 of them failed to provide sex-disaggregated results.
This data is especially damaging to women, who have traditionally been underrepresented in medical research. Women’s participation in the research fields exploring cardiovascular disease, HIV, chronic kidney disease, digestive disease, and hepatitis shows the most discrepancy, according to research, and does not match the numbers of women these diseases affect in the real world. With Covid19, as scientists develop entirely new diagnostic and treatment options, the medical community had an opportunity to right this pervasive wrong, but don’t seem to have addressed it yet. A few of the 11 trials the researchers evaluated, for example, were regarding the drug hydroxychloroquine, which was found to cause cardiac problems in patients — an issue we know is historically more prevalent in women. Without disaggregating their results on the basis of sex, these trials run the risk of ignoring a potentially deadly drawback of the drug for almost half of the world’s population.
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“Women are not just small men. We have different hormones [levels], smaller kidneys, and more fat tissue where drugs can accumulate,” Dr. Cara Tannenbaum, a scientific director at the Canadian Institutes of Health Research, told The Guardian. “There’s so many reasons why things can go wrong.”
The researchers add that it’s not just enough to include women in the recruitment process of these trials, as if to check off an inclusivity box. It’s imperative to do sex-based analysis, publish sex-based findings, to be able to obtain a comprehensive picture of new therapies for Covid19. Women make up an integral part of society, of the Covid19 healthcare force, and largely as essential workers. If we’re accruing the benefits of their work on the frontlines, then the least we can do is make sure we consider them in the fight to find solutions.
