Cirkel Anna, Göbel Hartmut, Göbel Carl, Alkatout Ibrahim, Khalil Ahmed, Baum Sascha, Brüggemann Norbert, Rody Achim, Cirkel Christoph
Department of Neurology, University Hospital Schleswig Holstein, Luebeck, Germany.
Kiel Migraine and Headache Centre, Kiel, Germany.
Womens Health Rep (New Rochelle). 2024 Sep 13;5(1):671-679. doi: 10.1089/whr.2024.0049. eCollection 2024.
Women are more at risk for developing long-term symptoms after a COVID-19 infection. Only limited data are available for patients with coexisting endometriosis and/or menstrual pain symptoms.
A total of 840 premenopausal women with menstrual pain and/or endometriosis were included in this observational cross-sectional study using an online survey platform.
A total of 840 women with menstrual pain (mean age 30.7 ± 6.9, 15-54 years) were studied. Of these, 714 (84.2%) had a COVID-19 infection, 123 did not (14.5%). A total of 312 subjects had acute COVID-19 (AC) with symptoms ≤4 weeks (43.7%), 132 (18.5%) developed postacute COVID-19 syndrome (PC), and 88 (12.3%) had "" (LC). There were no statistical differences regarding number of vaccination shots between the three groups AC, PC, and LC. A total of 582 patients with surgically confirmed endometriosis (SCE) showed a twofold increased risk of LC [odds ratio (OR): 2.12, 2.18-3.84] in comparison with AC subjects. In SCE the comorbidity anxiety disorder (OR: 2.08, 1.14-3.81) and depression (OR: 2.02, 1.15-3.56) further increased the risk of LC. LC subjects had a significantly higher disturbance level of menstrual pain ( = 0.002), were more restricted in job ( < 0.001), leisure ( = 0.002), and family activities ( < 0.001), and had a higher number of endometriosis surgeries ( = 0.003).
Subjects with SCE had a twofold increased risk of LC (in comparison to subjects with nonconfirmed endometriosis menstrual pain). In patients with SCE concomitant diagnosis of depression or anxiety disorder further twice-fold increased risk of LC. Further studies are needed if it is possible to reduce LC risk by improving the treatment of those secondary diagnoses and whether the type of endometriosis treatment can reduce LC occurrence (holistic, coanalgetic, hormonal).
感染新冠病毒后，女性出现长期症状的风险更高。关于同时患有子宫内膜异位症和/或经期疼痛症状的患者，现有数据有限。
本观察性横断面研究通过在线调查平台纳入了840名有经期疼痛和/或子宫内膜异位症的绝经前女性。
共研究了840名有经期疼痛的女性（平均年龄30.7±6.9岁，15 - 54岁）。其中，714人（84.2%）感染了新冠病毒，123人未感染（14.5%）。共有312名受试者患有急性新冠病毒感染（AC），症状持续≤4周（43.7%），132人（18.5%）出现了急性新冠后综合征（PC），88人（12.3%）患有“长期新冠”（LC）。AC、PC和LC三组之间的疫苗接种次数无统计学差异。与AC组受试者相比，582名经手术确诊为子宫内膜异位症（SCE）的患者出现LC的风险增加了两倍[比值比（OR）：2.12，2.18 - 3.84]。在SCE患者中，合并焦虑症（OR：2.08，1.14 - 3.81）和抑郁症（OR：2.02，1.15 - 3.56）进一步增加了LC的风险。LC组受试者的经期疼痛干扰水平显著更高（P = 0.002），在工作（P < 0.001）、休闲活动（P = 0.002）和家庭活动（P < 0.001）方面受到的限制更大，且子宫内膜异位症手术次数更多（P = 0.003）。
SCE患者出现LC的风险增加了两倍（与未确诊子宫内膜异位症经期疼痛的患者相比）。在SCE患者中，同时诊断出抑郁症或焦虑症会使LC风险进一步增加两倍。是否可以通过改善这些继发诊断的治疗来降低LC风险，以及子宫内膜异位症的治疗类型（整体治疗、联合镇痛、激素治疗）是否可以减少LC的发生，还需要进一步研究。
