Evaluation of Long-COVID Syndrome in a Cohort of Patients with Endometriosis or Adenomyosis, 2025, Xholli et al

Evaluation of Long-COVID Syndrome in a Cohort of Patients with Endometriosis or Adenomyosis

Anjeza Xholli, Isabella Perugi, Francesca Cremonini, Ambrogio Pietro Londero, Angelo Cagnacci

Background:
Long-COVID is characterized by the persistency of COVID-19 symptoms beyond 12 weeks, and it is probably consequent to immune dysregulation induced by SARS-CoV-2 infection. Immune dysregulation is associated with and probably involved in the pathogenesis of chronic gynecological conditions like endometriosis and adenomyosis. This study evaluated whether the presence of endometriosis or adenomyosis increases the risk of long-COVID, i.e., the persistence of COVID-19 symptoms beyond 12 weeks since infection.

Methods:
This retrospective observational study was performed at the outpatient service for endometriosis and chronic pelvic pain, at a university hospital. The diagnosis of endometriosis/adenomyosis was primarily based on clinical symptoms and ultrasonography assessment. Data regarding infection, vaccination, symptoms associated with SARS-CoV-2 infection, and their persistence for a minimum of 12 weeks were collected.

Results:
This study included 247 women, 149 controls without and 98 cases with endometriosis/adenomyosis. Among these, 194 (116 controls and 78 cases) had suffered from SARS-CoV-2 infection. Rates of infection and vaccination were similar in the two groups. The distribution of the SARS-CoV-2 vaccine was uniform across the two cohorts. COVID-19 patients with endometriosis or adenomyosis exhibited a higher prevalence (p < 0.001) of dyspnea and chest pain. The prevalence of long-COVID beyond 12 weeks was higher in cases than controls (42% vs. 12%; p < 0.001) with chest pain (p < 0.001) and ageusia (p < 0.05), forming the most representative symptoms.

Conclusions:
Symptoms of long-COVID are more frequent in women with than without endometriosis/adenomyosis.

Link | PDF (Journal of Clinical Medicine) [Open Access]

 

* p < 0.05; ** p < 0.002; *** p < 0.001 vs. cases (the p-values refer to the chi-squared test or Fisher’s exact test).

 

Asthenia = general fatigue and weakness.

Given that fatigue is one of the most common LC symptoms, it’s unexpected to see it reported in only ~20 % of the cases.

 

Given that above 90% of controls are reporting cough as a LC symptom, above 40% are reporting ansomia and above 50% are reporting ageusia you can be fairly sure that the authors don't even have their "controls in order", so it might be hard to take any of the rest serious.

 

Women with endometriosis and adenomyosis have their pain dismissed repeatedly over many years and even decades. Perhaps they just don't recognise pain from Long Covid as being different from their usual pain.

 

I’ve heard that from friends, so I think it’s plausible. But they would still report having pain? I don’t think they asked about the source of the symptoms, but the prevalence. I have not checked.