The impact of COVID-19 pandemic on women with endometriosis: a retrospective cohort study on referral center population

BACKGROUND: Patients with endometriosis are thought to have been impacted by the COVID-19 pandemic and estimates suggest that 6.2% of them were infected with SARS-CoV-2. METHODS: This is a retrospective cohort study enrolling 284 women at the Polyclinic of Modena between January 2020 and April 2021. Patients were given specific questionnaires to investigate COVID-19 infection and any changes in gynecological symptoms. All patients were also administered the Hospital Anxiety and Depression Syndrome (HADS) Questionnaire to assess the psychological impact of the COVID-19 pandemic. The primary outcome was to assess the clinical impact and any worsening of gynecological symptoms after COVID-19 infection; the secondary outcome was to evaluate the clinical and psychological impact of the COVID-19 pandemic in patients with endometriosis or chronic pelvic pain. RESULTS: A total of 170 women experienced COVID-19 infection, while 114 were consistently negative and asymptomatic for COVID-19. The two groups showed similar baseline. A total of 122 women with COVID-19 infection and 106 COVID-19 negative patients had already the vaccine administration with two doses of vaccine (72.20% vs. 93%, P=0.001). Among the 170 patients affected by COVID-19, 41 (24%) reported worsening gynecologic endometriosis symptoms, during the infection. According to our results, 196 of 284 reported changes in their gynecological health status during pandemic, and 84 reported symptomatic worsening (42.9%); 24% of patients with infection reported feeling slowed down vs. 15.8% of unaffected patients (P=0.065) and 44% of positive patients reported loss of interest in self-care vs. 31% of negative patients (P=0.055). CONCLUSIONS: Patients with endometriosis seemed to have worsening gynecological and psychological clinical status during the pandemic.