As of June 3rd 2020, with 233,515 confirmed cases [
8] Italy was the sixth Country in the world after USA, Brazil, Russia, United Kingdom, and Spain in patient numbers. According to the COVID-19 Italian Integrated Surveillance [
9], at June 3rd 2020, the male/female cases ratio was approximately 1 (men 45.9%, women 54.1%) in Italy. Hospitalizations prevailed in males in all the age groups [
10] and, accordingly, a more severe clinical course was observed. Interestingly enough, the same results also emerged from the analysis of the Italian Workers’ Compensation Authority, the National Institute for Insurance against Accidents at Work [
11]. At April 21st 2020, 28,381 accidents at work were reported and represented by 71.1% females and 28.9% males. Fatal cases however displayed an inverse picture with 20.4% women and 79.6% men, most grouped within 50–64 years old (68.4%) [
11]. As a fact, more men required intensive care than women in all the age groups including the older patients [
10]. Regarding the age distribution of the total deaths, at June 3rd 2020, almost 85% were confined after 69 years (70–79 year age group 26.8%, 80–89 years age group 40.9%, older than 90 years 17.4%) [
9]. When considering the absolute number of deaths by age group, women dying for SARS-CoV-2 infection had an older age than men (median age 85 vs 79 years) [
10]. As a confirm of this National panorama, in a large cohort of more than 1500 patients of the Lombardy Region admitted to ICUs, men represented more than 80% of the patients just after 40 years of age [
12]. In Florence, the COCORA multidisciplinary group found that hospitalized patients were prevalently males (65.5% vs 34.5%, p 0.045) and a strikingly majority were ICU-transferred (87.5% vs 12.5%) [
13]. Thus, within Italy, severe clinical course and deaths from COVID-19 are mainly observed among older, male patients confirming lower rates of severe disease among women and younger individuals overlapping data initially described in China [
14]. This disparity, however, is not observed in comorbidities. Their quality, quantity and association are equally distributed and do not differ between the two sexes [
15]. As a fact, among deceased patients, cardiovascular diseases including hypertension were the most common comorbidities both in men and in women and the median number of pre-existing chronic pathologies was 3 in women as well as in men [
10]. This also suggests that co-existing pathologies, although representing risk factors for severe course, cannot fully explain the observed sex difference in COVID-19.