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Meta-Analysis
. 2025 May 15;25(1):229.
doi: 10.1186/s12905-025-03761-9.

Long COVID and endometriosis: a systematic review and meta-analysis

Alexandre Vallée  1   2 , Maxence Arutkin  3   4 , Pierre-François Ceccaldi  5 , Anis Feki  6 , Jean-Marc Ayoubi  5   7
Affiliations
Meta-Analysis

Long COVID and endometriosis: a systematic review and meta-analysis

Alexandre Vallée et al. BMC Womens Health. .

Abstract

Long COVID conditions entail the persistence of COVID-19-related symptoms for at least eight weeks following SARS-CoV-2 infection. The prevalence of long COVID is estimated to range from 10 to 30% among individuals infected with SARS-CoV-2. Despite its growing impact on healthcare systems, long COVID remains poorly understood. In parallel, endometriosis, a chronic inflammatory condition affecting around 10% of reproductive-age women, is marked by symptoms such as pelvic pain and infertility. The aim of this study was to assess the association between endometriosis and long COVID. We performed a systematic review of long COVID among endometriosis patients in Pubmed/Medline, Cochran Library and Science Direct databases from inception to August 2023. We independently selected studies, extracted data, assessed risk of bias, and compared endometriosis versus non endometriosis patients for long. Pooled analyses were based on random-effect models, and the I2 statistic was used to quantify heterogeneity across studies. A total of 2 cross-sectional studies (N = 216,095 participants) were included. The pooled analysis comparing endometriosis to non-endometriosis patients significantly showed association for long COVID (pooled RR = 1.41 [1.31-1.52], I2 = 29%, p < 0.001). Women, who are disproportionately affected by long COVID, particularly those with endometriosis, may face compounded health challenges. While our findings suggest a possible association between endometriosis and long COVID, the evidence is currently limited to two observational studies. Further research involving diverse populations and robust study designs is needed to confirm this relationship and clarify underlying mechanisms.

Keywords: ACE2; COVID-19; Endometriosis; Inflammation; SARS-CoV-2; long-COVID.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Conflict of interest: The authors declare no conflict of interest with this work.

Figures

Fig. 1
Fig. 1
Flow diagram of the included studies
Fig. 2
Fig. 2
Prevalence and risk of long COVID in endometriosis patients
Fig. 3
Fig. 3
Risk of bias and quality assessment of studies
Fig. 4
Fig. 4
Funnel plot of studies
See this image and copyright information in PMC

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