Increased COVID-19 infections in women with polycystic ovary syndrome: a population-based study.
Several recent observational studies have linked metabolic co-morbidities to an increased risk from COVID-19. Here we investigated whether women with PCOS are at an increased risk of COVID-19 infection.Population-based closed cohort study between 31st January 2020 and 22nd July 2020 in the setting of a UK primary care database (The Health Improvement Network, THIN).Main outcome was incidence of COVID-19 coded as suspected or confirmed by the primary care provider. We used Cox proportional hazards regression model with stepwise inclusion of explanatory variables (age, body mass index, impaired glucose regulation, androgen excess, anovulation, vitamin D deficiency, hypertension, and cardiovascular disease) to provide unadjusted and adjusted hazard risks (HR) of COVID-19 infection among women with PCOS compared to women without PCOS.We identified 21,292 women with a coded diagnosis of PCO/PCOS and randomly selected 78,310 age and general practice matched control women. The crude COVID-19 incidence was 18.1 and 11.9 per 1,000 person-years among women with and without PCOS, respectively. Age-adjusted Cox regression analysis suggested a 51% higher risk of COVID-19 among women with PCOS compared to women without PCOS (HR: 1.51 [95% CI 1.27-1.80], p<0.001). After adjusting for age and BMI, HR reduced to 1.36 [1.14-1.63], p=0.001. In the fully adjusted model, women with PCOS had a 28% increased risk of COVID-19 (aHR: 1.28 [1.05-1.56], p=0.015).Women with PCOS are at an increased risk of COVID-19 infection and should be specifically encouraged to adhere to infection control measures during the COVID-19 pandemic.
Authors: Anuradhaa Subramanian, Astha Anand, Nicola J Adderley, Kelvin Okoth, Konstantinos A Toulis, Krishna Gokhale, Christopher Sainsbury, Michael W O’Reilly, Wiebke Arlt, Krishnarajah Nirantharakumar