Research indicates that individuals with PCOS are at a 28-50% higher risk of being infected with COVID-19.[1],[2],[3] A definitive causal link has not yet been established.[4] When individuals with PCOS do contract COVID-19 they are also at risk of more severe outcomes, including higher rates of hospitalization, morbidity and mortality.[5],[6] In this article, we explore the link between PCOS and COVID-19.
COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. To enter cells, the virus requires two enzyme receptors, angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2), on the cell membrane.[7]
Individuals with PCOS are considered to be at higher risk from COVID-19 due to:
Increased prevalence of obesity and other cardio-metabolic health conditions (see below);
Increased activity of TMPRSS2 due to increased androgen levels (which partly explains the higher risk of COVID-19 in biological men);[8],[9]
Higher prevalence of Vitamin D deficiency (60%, almost double the population norm of 24% in the US), associated with an impaired immune system;[10],[11],[12]
Higher prevalence of gut dysbiosis (higher levels of “bad bacteria” such as Escherichia and Shigella and lower levels of “good bacteria” such as a Lactobacilli and Bifidobacteria), associated with an impaired immune system and low-grade inflammation.[13],[14]
Risk factors for increased rates of contracting COVID-19 include:[15]
Sharing a home with someone who has COVID-19;
Spending time in places with poor air circulation and high numbers of people; and
Spending more than 30 minutes in close contact with someone who has COVID-19.
Risk factors for more severe outcomes from COVID-19 include:[16],[17],[18],[19],[20]
Dyslipidemia, having abnormal levels of lipids or fats I the bloodstream;[21]
Obesity, having a body mass index (BMI) of 40 or greater;
Diabetes mellitus, having either Type 1 or Type 2 diabetes;
Heart disease, including hypertension, heart failure or coronary heart disease;
Another pre-existing chronic condition such as lung, liver or kidney disease, Alzheimer’s, Sickle cell disease or thalassemia;
Black or South Asian ethnicity;[22]
Increasing age, especially over 60 years;
Being pregnant;
Having Down Syndrome;
Being immunocompromised due to an underlying condition such as HIV or medical treatments such as solid organ or bone marrow transplants; and
Not being up to date with COVID-19 vaccinations.
Reviewed by Sandra Multiva PhD, EMBA, CHE, CRM, BHSc RM(Ret)
Sources
[1] https://pubmed.ncbi.nlm.nih.gov/33065278/
[2] https://pubmed.ncbi.nlm.nih.gov/35218458/
[3] https://pubmed.ncbi.nlm.nih.gov/33635829/
[4] https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1229900/full
[5] https://pubmed.ncbi.nlm.nih.gov/33065278/
[6] https://pubmed.ncbi.nlm.nih.gov/35218458/
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881900/
[8] https://pubmed.ncbi.nlm.nih.gov/33065278/
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881900/
[10] https://pubmed.ncbi.nlm.nih.gov/33065278/
[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881900/
[12] https://www.nature.com/articles/s41430-020-0558-y
[13] https://pubmed.ncbi.nlm.nih.gov/33065278/
[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863528/
[15] https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963
[16] https://pubmed.ncbi.nlm.nih.gov/35218458/
[17] https://www.news-medical.net/news/20230609/SARS-CoV-2-hijacks-bodys-metabolism-to-amplify-COVID-19-severity.aspx
[18] https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks.html
[19] https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-who-is-at-risk/art-20483301
[20] https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963
[21] https://www.ncbi.nlm.nih.gov/books/NBK560891/
[22] https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/coronavirusrelateddeathsbyethnicgroupenglandandwales/2march2020to10april2020#ethnic-group-differences-in-deaths-involving-covid-19-adjusted-for-main-socio-demographic-factors
Other Conditions