Case reports of patients with COVID-19 exhibited similar sex and gender bias seen in previous studies, including an overrepresentation of male patients, according to a study published in Frontiers in Global Women’s Health.

As sex and gender are increasingly recognized as important biological variables, recognition of theses biases is an important step towards changing them, according to Nicole Woitowich, PhD, research assistant professor of Medical Social Sciences and senior author of the study.

“It’s imperative that we strive to present sex- and gender-balanced information in both educational and research settings,” said Woitowich.

Woitowich and her collaborators analyzed nearly 500 clinical case reports of patients with COVID-19: 45 percent were male and 30 percent were female, and only 25 percent of case reports included patients of both sexes.

Case reports with male senior authors were more likely to include male-only patients, compared to case reports with female last authors. Female authors were also more likely to include patients of both sexes.

Unbalanced genders in biomedical science are not a new phenomenon, Woitowich said, but the novelty of COVID-19 means it’s especially important to understand any gender differences in illness — an understanding that’s made difficult by gender bias in case reports.

“I think the biomedical community has made forward strides in acknowledging how conscious and unconscious biases may inform decision-making and clinical care,” Woitowich said. “Yet, this work indicates that there is much more work to do — and this may fall upon journal editors to ensure that the reports which do get published are representative and balanced.”

This work was supported by a Women’s Health Access Matters Grant.