COVID-19: Cultural predictors of gender differences in global prevalence patterns

Puzzling differences are emerging between male and female infection and death rates for COVID-19 (Cai, 2020). We predict that this may be amplified, especially in the developing world, due to hitherto overlooked cultural factors. Currently, credible data from low- and lower middle-income countries on COVID-19 are sparse, with recorded case numbers seemingly suppressed by unreliable surveillance, lesser testing capacity and an underlying burden of infectious diseases that may mimic key symptoms, notably pyrexia. Indeed, acute undifferentiated febrile illness is a common feature of resource-limited tropical regions. Patterns of prevalence of vector-borne diseases in the developing world, however, offer an indication of likely COVID-19 infection and morbidity gender trends.