Endometriosis and susceptibility to COVID-19

Endometriosis patients may have modified presenting symptoms of Covid-19

Key Points

Highlights:

• The presence of endometriosis does not increase the risk of susceptibility to COVID-19. The symptoms and the manifestation of COVID-19 may be different in endometriosis patients.

Importance:

• Endometriosis, as an inflammatory disease, may risk the patients being more susceptible to COVID-19 when compared to the healthy subjects.
• There is an urgent need to compare the risk of COVID-19 between women with and without endometriosis, to take necessary measures for prevention.

What's done here:

• This retrospective study compares 507 women with endometriosis to 520 women without endometriosis (control group).
• Signs and symptoms of COVID-19 infection along with other medical parameters (hospitalization, isolation, H1N1 infection and vaccination, and past medical history) were recorded.
• Patient and the control groups compared with appropriate statistical analysis.

Key Results:

• There is no statistically significant difference in the prevalence of COVID-19 infection in the endometriosis and the control groups. 
• Asymptomatic infection and fever are more common in the control group.
• Endometriosis patients show rather rare symptoms compared to others.
• After comparing all medical parameters, endometriosis does not increase the susceptibility to COVID-19 infections.
• The prevalence of the disease could depend on the individual’s immune system as has already been suggested, and further studies are required in this regard. 

Limitations:

• The cross-sectional nature and lack of follow-up are the main limitations. 
• Due to this major drawback, only suggestions rather than the causal relationship between the study variables were made.

Lay Summary

Dr. Moazzami and associates from Pars Advanced and Minimally Invasive Medical Manners Research Center, Tehran, Iran have published their results on COVID-19 in endometriosis patients in the medical journal named "BMC’s Women’s Health".

COVID-19 is still an emerging critical global health problem with plenty of research studying the associated factors. It is not clear whether endometriosis increases the risk of COVID-19. Being an inflammatory disease, endometriosis may risk the patients being more susceptible to COVID-19. If this is the case, more specific treatment guidelines become necessary in order to reduce the susceptibility of endometriosis patients to COVID-19 infection.

In this study, referrals to a major hospital, Gynecology Department in Tehran, 507 women with endometriosis were compared to 520 women of reproductive age without endometriosis.

Signs and symptoms of COVID-19 infection along with other clinical variables such as hospitalization, isolation, previous H1N1 infection, and vaccination, past medical history of the participants were recorded and compared statistically between the two groups. The control group had a higher frequency of asymptomatic infection and fever, while the frequency of rare symptoms was statistically significantly more common in the endometriosis group.

The results of comparing the COVID-19 characteristics between the endometriosis and control groups showed no difference. The association of the study variables with COVID-19 infection identified “close contact with a person with COVID-19 infection” as a significant risk factor, both in the endometriosis and control groups. However, the comparison of the two groups showed that endometriosis could modify the presenting symptoms. 

The authors suggest paying more attention to accurate diagnosis of COVID-19 in women with endometriosis. Preventive measures, as have already been put forward should be considered to minimize contact with infected persons, especially in the incubation or asymptomatic period, to reduce the transmission rate and the prevalence of this global COVID-19 disaster.

"Endometriosis does not increase the susceptibility to COVID-19 infection but alters the manifestation of the disease. The prevalence of the disease may depend on the interaction between the virus and the individual’s immune system, but further studies are required in this regard" the authors concluded.

Research Source: https://pubmed.ncbi.nlm.nih.gov/33752656/