Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York.
Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania.
Fertil Steril. 2023 May;119(5):847-857. doi: 10.1016/j.fertnstert.2023.01.025. Epub 2023 Jan 21.
To determine whether women with polycystic ovary syndrome (PCOS) had a higher incidence of testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than those without PCOS and evaluate whether PCOS diagnosis independently increased the risk of moderate or severe disease in those with positive SARS-CoV-2 test results.
Retrospective cohort study using the National COVID Cohort Collaborative (N3C).
National COVID Cohort Collaborative.
PATIENT(S): Adult nonpregnant women (age, 18-65 years) enrolled in the N3C with confirmed SARS-CoV-2 testing for any indication. Sensitivity analyses were conducted in women aged 18-49 years and who were obese (body mass index, ≥30 kg/m).
INTERVENTION(S): The exposure was PCOS as identified by the N3C clinical diagnosis codes and concept sets, which are a compilation of terms, laboratory values, and International Classification of Diseases codes for the diagnosis of PCOS. To further capture patients with the symptoms of PCOS, we also included those who had concept sets for both hirsutism and irregular menses.
MAIN OUTCOME MEASURE(S): Odds of testing positive for SARS-CoV-2 and odds of moderate or severe coronavirus disease 2019 (COVID-19) in the PCOS cohort compared with those in the non-PCOS cohort.
RESULT(S): Of the 2,089,913 women included in our study, 39,459 had PCOS. In the overall cohort, the adjusted odds ratio (aOR) of SARS-CoV-2 positivity was 0.98 (95% confidence interval [CI], 0.97-0.98) in women with PCOS compared to women without PCOS. The aORs of disease severity were as follows: mild disease, 1.02 (95% CI, 1.01-1.03); moderate disease, 0.99 (95% CI, 0.98-1.00); and severe disease, 0.99 (95% CI, 0.99-1.00). There was no difference in COVID-19-related mortality (aOR, 1.00; 95% CI, 0.99-1.00). These findings were similar in the reproductive-age and obese reproductive-age cohorts.
CONCLUSION(S): Women with PCOS had a similar likelihood of testing positive for SARS-CoV-2. Among those who tested positive, they were no more likely to have moderate or severe COVID-19 than the non-PCOS cohort. Polycystic ovary syndrome is a chronic condition associated with several comorbidities, including cardiovascular disease and mental health issues. Although these comorbidities are also associated with COVID-19 morbidity, our findings suggest that the comorbidities themselves, rather than PCOS, drive the risk of disease severity.
确定多囊卵巢综合征（PCOS）女性与无 PCOS 女性相比，新冠病毒检测呈阳性的比例是否更高，并评估 PCOS 诊断是否会独立增加新冠病毒检测呈阳性患者发生中重度疾病的风险。
使用国家 COVID 队列协作（N3C）的回顾性队列研究。
国家 COVID 队列协作。
纳入 N3C 的年龄在 18-65 岁之间的成年非孕妇，因任何原因接受 SARS-CoV-2 检测。在年龄在 18-49 岁之间和肥胖（体重指数≥30kg/m²）的女性中进行了敏感性分析。
暴露是通过 N3C 临床诊断代码和概念集确定的 PCOS，这是一组用于 PCOS 诊断的术语、实验室值和国际疾病分类代码。为了进一步捕获有 PCOS 症状的患者，我们还包括了那些有毛发过多和不规则月经概念集的患者。
与非 PCOS 队列相比，PCOS 队列中 SARS-CoV-2 检测呈阳性的可能性，以及中重度 2019 年冠状病毒病（COVID-19）的可能性。
在我们的研究中，纳入了 2089913 名女性，其中 39459 名患有 PCOS。在总体队列中，与无 PCOS 女性相比，患有 PCOS 的女性 SARS-CoV-2 阳性的调整比值比（aOR）为 0.98（95%置信区间[CI]，0.97-0.98）。疾病严重程度的 aOR 如下：轻症，1.02（95%CI，1.01-1.03）；中度疾病，0.99（95%CI，0.98-1.00）；重症疾病，0.99（95%CI，0.99-1.00）。COVID-19 相关死亡率无差异（aOR，1.00；95%CI，0.99-1.00）。在生殖年龄和肥胖生殖年龄队列中也有类似的发现。
患有 PCOS 的女性 SARS-CoV-2 检测呈阳性的可能性相似。在检测呈阳性的患者中，他们发生中重度 COVID-19 的可能性与非 PCOS 队列没有差异。多囊卵巢综合征是一种与多种合并症相关的慢性疾病，包括心血管疾病和心理健康问题。尽管这些合并症也与 COVID-19 的发病率有关，但我们的研究结果表明，是合并症本身而不是 PCOS 导致了疾病严重程度的风险。
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