Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Republic of Ireland.
Eur J Endocrinol. 2021 May;184(5):637-645. doi: 10.1530/EJE-20-1163.
Several recent observational studies have linked metabolic comorbidities to an increased risk from COVID-19. Here we investigated whether women with PCOS are at an increased risk of COVID-19 infection.
Population-based closed cohort study between 31 January 2020 and 22 July 2020 in the setting of a UK primary care database (The Health Improvement Network, THIN).
The main outcome was the incidence of COVID-19 coded as suspected or confirmed by the primary care provider. We used Cox proportional hazards regression model with stepwise inclusion of explanatory variables (age, BMI, impaired glucose regulation, androgen excess, anovulation, vitamin D deficiency, hypertension, and cardiovascular disease) to provide unadjusted and adjusted hazard risks (HR) of COVID-19 infection among women with PCOS compared to women without PCOS.
We identified 21 292 women with a coded diagnosis of PCO/PCOS and randomly selected 78 310 aged and general practice matched control women. The crude COVID-19 incidence was 18.1 and 11.9 per 1000 person-years among women with and without PCOS, respectively. Age-adjusted Cox regression analysis suggested a 51% higher risk of COVID-19 among women with PCOS compared to women without PCOS (HR: 1.51 (95% CI: 1.27-1.80), P < 0.001). After adjusting for age and BMI, HR reduced to 1.36 (1.14-1.63)], P = 0.001. In the fully adjusted model, women with PCOS had a 28% increased risk of COVID-19 (aHR: 1.28 (1.05-1.56), P = 0.015).
Women with PCOS are at an increased risk of COVID-19 infection and should be specifically encouraged to adhere to infection control measures during the COVID-19 pandemic.
Women with polycystic ovary syndrome (PCOS) have an increased risk of cardio-metabolic disease, which have been identified as a risk factor for COVID-19. To investigate whether the increased metabolic risk in PCOS translates into an increased risk of COVID-19 infection, we carried out a population-based closed cohort study in the UK during its first wave of the SARS-CoV-2 pandemic (January to July 2020), including 21 292 women with PCOS and 78 310 controls matched for sex, age and general practice location. Results revealed a 52% increased risk of COVID-19 infection in women with PCOS, which remained increased at 28% above controls after adjustment for age, BMI, impaired glucose regulation and other explanatory variables.
最近几项观察性研究表明，代谢合并症与 COVID-19 风险增加有关。在这里，我们研究了多囊卵巢综合征（PCOS）女性是否有更高的 COVID-19 感染风险。
在英国初级保健数据库（健康改善网络，THIN）中，于 2020 年 1 月 31 日至 2020 年 7 月 22 日期间进行基于人群的封闭队列研究。
主要结局是由初级保健提供者编码为疑似或确诊的 COVID-19 发生率。我们使用 Cox 比例风险回归模型，逐步纳入解释变量（年龄、BMI、葡萄糖调节受损、雄激素过多、排卵障碍、维生素 D 缺乏、高血压和心血管疾病），以提供 PCOS 女性与无 PCOS 女性相比 COVID-19 感染的未经调整和调整后的危险比（HR）。
我们确定了 21292 名经编码诊断为 PCO/PCOS 的女性，并随机选择了 78310 名年龄和一般实践匹配的对照女性。有 PCOS 和无 PCOS 的女性 COVID-19 的粗发病率分别为 18.1 和 11.9/1000 人年。年龄调整的 Cox 回归分析表明，与无 PCOS 女性相比，PCOS 女性 COVID-19 的风险高 51%（HR：1.51（95%CI：1.27-1.80），P<0.001）。调整年龄和 BMI 后，HR 降至 1.36（1.14-1.63），P=0.001）。在完全调整的模型中，PCOS 女性 COVID-19 的风险增加 28%（aHR：1.28（1.05-1.56），P=0.015）。
PCOS 女性患 COVID-19 的风险增加，应特别鼓励她们在 COVID-19 大流行期间遵守感染控制措施。
患有多囊卵巢综合征（PCOS）的女性患心血管代谢疾病的风险增加，而心血管代谢疾病已被确定为 COVID-19 的危险因素。为了研究 PCOS 中增加的代谢风险是否转化为 COVID-19 感染的风险增加，我们在英国进行了一项基于人群的封闭队列研究，该研究纳入了 21292 名患有 PCOS 的女性和 78310 名年龄和一般实践地点匹配的对照女性。结果显示，患有 PCOS 的女性 COVID-19 感染风险增加 52%，调整年龄、BMI、葡萄糖调节受损和其他解释变量后，该风险仍比对照组高 28%。
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