Sex and age Differences in Hospitalization and Mortality Rates Due to COVID-19 from 20 March 2020 until 20 March 2022 in Iran: A Population-based Study

This study aimed to identify the effect of differences in age-sex structure in COVID-19 hospitalizations and death rates among men and women in Iran. Accordingly, we calculated the SARS-CoV-2 hospitalized patients and mortality rates, stratified by sex, age, and demographic distribution.

This was a cross-sectional study, where the target population was the total population from 20 March 2020 until 20 March 2022 in Iran, over the two-time periods, 20 March 2020 until 20 March 2021 [first year], and 20 March 2021 until 20 March 2022 [second year]. The chi-squared test was used for analysis.

During the first year, 493220 cases were hospitalized with 258209 (52%) men, in addition 61,586 deaths occurred, where 34,849 [57%] were men. The overall hospitalization rate per 100,000 population in men and women was 607.77 and 565.57, respectively, and the mortality rate per 100,000 population in men and women was 82.03 and 64.34, respectively. During the second year, 652893 cases were hospitalized, where 340344 (52%) were women. The overall hospitalization rate per 100,000 population in men and women was 727.98 and 809.67, respectively, in addition to 54,740 deaths, where 29,172 [53%] were men. The overall mortality rate per 100,000 population in men and women was 67.95 and 60.83, respectively.

The findings showed a higher hospitalization in the first year in men, whilst the opposite was evident in the second year. The mortality rate increased with age and was most predominant in men, 50 years of age or older. Therefore, there is a need for policy makers to be acutely aware of the discrepancies in mortality according to age and sex groups, and have different, and complementary, strategies for controlling the pandemic by age and sex groups.