Background In the context of the Covid-19 pandemic, several factors such as age, chronic disease or obesity have been associated with adverse outcomes and mortality from Covid-19. However, the social distribution of Covid-19 infection among men and women was largely neglected in France, mainly due to a lack of data. The aim of this study is to describe and analyse the risk of Covid-19 infection in relation to sex, and the influence of other social factors, specifically occupation, in this association.
Methods We used data from the citizen science initiative ‘Baromètre Covid-19’. Each week, an internet survey was administered to a sample of 5,000 people representative of the French mainland population aged 18 and over, using the quota method. A total of 25,001 participants were interviewed between 7 April and 11 May 2020. We used multivariable nested logistic regression modelling to study the relationship between sex, occupation and Covid-19 infection. Confounders included age, region of residence, population density, whether you worked outside of home during the lockdown, house overcrowding, comorbidities and body mass index.
Results Women reported a medical diagnosis of Covid-19 infection more often than men (4% vs. 3.2%). In a model adjusted for confounders, women were 23% more likely to report a medical diagnosis of Covid-19 infection than men (OR=1.23 [95%-CI=1.06–1.42]). Controlling for sex and socioeconomic variables (occupation), the risk of infection for women was reversed (OR=0.84 [95%-CI=0.59–1.19]). While most men, other than executives, were less likely to report the infection, this association was not observed amongst women.
Conclusion Occupation was found to influence the relationship between sex and Covid-19 infection suggesting a gender effect. The differences in the risk of infection between men and women require exploration with regard to socioeconomic factors. The social roles of women and men are associated with a non-random distribution of the virus, potentially reflecting structural societal inequalities.
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