Post-COVID-19 syndrome in early reproductive age women

Objective: To compare the incidence and severity of new persistent symptoms in young, somatically healthy women after novel coronavirus infection (NCI) with those who did not become ill during the pandemic.

Materials and methods: To assess the independent impact of COVID-19 on the development of post-COVID syndrome (PCS), this study included non-pregnant women under 35 years of age, without excess body weight/obesity, diabetes mellitus, chronic arterial hypertension, and other somatic and chronic infectious diseases. The study group included patients who recovered from SARS-CoV-2 infection between July and October 2021, as confirmed by PCR (n=181). The control group consisted of women who did not become ill during the study period (n=71). Clinical manifestations of PCS were defined as symptoms that were absent before COVID-19, occurred no earlier than four weeks after disease onset, lasted at least two months, and could not be explained by alternative diagnoses. A statistical database was formed based on primary medical documentation and an active survey of patients, using a special questionnaire with symptom assessment on a 10-point scale. The survey was conducted in the 1st phase of the menstrual cycle to exclude the symptoms of premenstrual syndrome, which have a clinical picture similar to that of PCS.

Results: The incidence of new persistent symptoms during the pandemic in young initially somatically healthy women who had recovered from COVID-19 and in the non-diseased group was similar:96.1% and 93.0%, respectively (OR=1.88 (95% CI 0.58; 6.14); p_χ2=0.327). Only patients who had NCI experienced symptoms such as coughing (43.6%), shortness of breath (26.5%), chest pain (18.2%), weight loss (18.8%), hair loss (60.8%) %) (in the comparison group 0.0%, p_χ2<0.001). Patients with PCS more often reported memory impairment – 49.2% vs. 12.7% (OR=6.66 (95% CI 3.13; 14.21); p_χ2<0.001); headache – 43.1% vs. 11.3% (OR=5.96 (95% CI 2.7; 13.17); p_χ2<0.001); depression – 19.9% vs. 8.5% (OR=2.69 (95% CI 1.08; 6.7); p_χ2=0.029); myalgia – 31.5% versus 8.5% (OR=4.98 (95% CI 2.04;12.17); p_χ2<0.001). Fatigue/fatigue (69.0% vs. 71.8%, p_χ2=0.66), drowsiness (54.9% vs. 43.6%, p_χ2=0.11), palpitations (19.7% vs. 29.8%, p_χ2=0.1), changes in menstrual cycle (22.5% vs. 21.0%, p_χ2=0.865), skin manifestations (2.8% vs. 6.6%, p_χ2=0.24), and insomnia developed significantly more frequently (32.4% vs. 26.0%, p_χ2=0.012). After COVID-19, the intensity of memory impairment (4.0 versus 1.0 points, p<0.001) and headache (5.0 versus 3.0 points; p=0.001) were more pronounced. Myalgia (5.0 vs. 1.0 points, p<0.001), and insomnia (3.0 versus 5.0 points; p=0.004) were less severe.

Conclusion: PCS is highly prevalent among initially somatically healthy women of early reproductive age. The occurrence of several similar symptoms of similar frequency in women who did not become ill during the pandemic may be associated with post-traumatic stress-anxiety disorder. Further in-depth interdisciplinary studies are required to elucidate the pathophysiological mechanisms underlying the development of new, persistent symptoms associated with the COVID-19 pandemic.