A new study may support the idea that men get sicker and are more likely to die from coronavirus than women, CNN reports.

It’s a small study, done in China, and does not necessarily reflect what has happened elsewhere in the world. But it supports an early observation about Covid-19 when it first started spreading in China: men were more likely to die than women.

A team at Beijing Tongren Hospital and Wuhan Union Hospital studied 43 patients directly and the records of just over 1,000 others.

Men and women seemed to get the disease at the same rate, but men were more than twice as likely to die, the team found. The study, published in the journal Frontiers in Public Health, gives little other detail.

People who were older and those with more underlying health conditions fared worse than younger and healthier patients, the researchers found.

More research needed is needed, however. The authors concluded that the male gender is a risk factor for worse outcomes of Covid-19, regardless of age and underlying health conditions. They said this will need to be studied with a larger group of patients to determine if it is accurate, although some earlier studies have noted a similar trend.

Scientists will also want to look at data from patients in other countries since there are demographic elements that could be a factor. In China, for example, 50% of men smoke, compared to 5% of women, according to earlier research, and smoking is thought to be tied to more severe cases of the disease. The study also does not explain why men fare worse with this disease.