Women With Polycystic Ovary Syndrome at Increased Risk for COVID-19

Women with polycystic ovary syndrome (PCOS) have an increased risk of COVID-19 infection, according to the results of a study published in the European Journal of Endocrinology.

The population-based closed-cohort study used information from The Health Improvement Network (THIN) databases which is comprised of electronic medical records from 356 active general practices in the United Kingdom. Women aged 18 years and older were included in the study.

A total of 1,012,944 women were included in the database, among whom 8103 had a diagnosis of PCOS and 13 189 had a a diagnosis of polycystic ovaries (PCO). Out of the rest of the population, 78 310 age- and location-matched women were selected as controls.

The group of women with and without PCOS or polycycstic ovaries  (PCO) were aged mean 39.3±11.1 and 39.5±11.3 years (P =.030) and BMI was 31.0±8.4 and 27.1±6.7 kg/m² (P <.001), respectively. The women with PCOS or PCO had more comorbidities, such as hypertension and cardiovascular disease, compared with controls.

Suspected or confirmed COVID-19 occurred among 0.85% of women with PCO/PCOS versus and 0.56% of the control cohorts (adjusted hazard ratio [aHR], 1.28; 95% CI, 1.05-1.56; P =.015).

Among  women of reproductive age (18-50 years), suspected or confirmed COVID-19 occurred among 0.87% and 0.55% of the PCO/PCOS cohort and controls, respectively (aHR, 1.30; 95% CI, 1.05-1.62; P =.018). A decreased risk of infection was shown in women 60 years of age and older (aHR, 0.41; 95% CI, 0.23-0.74; P =.003), according to the adjusted study model.

Other predictors for confirmed or suspected COVID-19 risk included cardiovascular disease (aHR, 1.88; 95% CI, 1.12-3.17; P =.017), vitamin D deficiency (aHR, 1.61; 95% CI, 1.05-2.47; P =.029), and increased BMI (aHR, 1.02; 95% CI, 1.01-1.03; P <.001).

Study authors said their analysis was limited by relying on medical records from general practitioners as opposed to endocrinologists, which they say may have resulted in an underestimated prevalence of PCOS.

The researchers concluded that women with PCOS had a 52% increased risk of COVID-19 infection, which remained increased at 28% above those in the control group. The risk, they added, was not mitigated by adjusting for potential cofactors (except for obesity), implying there may be inherent PCOS-specific factors elevating the risk of infection. The researchers suggested future studies should explore “the potentially critical role of androgens in conveying this risk and assess in more detail the contribution of ethnicity and socio-economic deprivation.”

Disclosure: Several authors declared affiliations with the health care industry. Please refer to the original article for a full list of disclosures.

Reference

Subramanian A, Anand A, Adderley NJ, et al. Increased COVID-19 infections in women with polycystic ovary syndrome: a population-based study. Eur J Endocrinol. 2021;184(5):637-645. doi:10.1530/EJE-20-1163