Background: In this article, we have reviewed available data on the frequency of endometriosis considering separately the incidence and the prevalence of the disease using data from papers published from 2000 to June 2019. Study design: Systematic review and meta-analysis. PubMed and EMBASE were searched for observational studies reporting data on the incidence or prevalence rates or ratios for the following pre-specified populations: general population, infertile women, women reporting pelvic pain, women who underwent pelvic surgical procedures unrelated with endometriosis. Results: A total of 42 papers were included in this review. Considering the 11 studies that have analysed the prevalence of endometriosis in the general population, the reported prevalence ranged from 0.8% to 28.6% with an overall estimated of 4.4% (95% CI 3.6–5.2). When we considered separately the estimates reported in each study according to geographic area, the pooled estimate was lower in the European studies (1.4%), increased to 5.7% in the US studies and was 15.4% in the Asian ones. The pooled estimated prevalence of endometriosis was 33.5% (95% CI 24.3–42.8, Figure 2(c)) in women who underwent surgery for benign gynaecological conditions, 23.8% (95% CI 16.1–31.5, Figure 2(d)) in infertile women, and 49.7 % (95% CI 14.4–85.0) in women with chronic pelvic pain. Conclusion: This review offers an overview of the available data on the frequency of endometriosis in the general population and in selected population, in particular among infertile women and women with chronic pelvic pain.
Problem
Starting from November 2019, the world has had to face a devastating pandemic caused by SARS‐CoV‐2. Various studies have identified potential risk factors facilitating the infection, however it has not been demonstrated whether endometriosis might represent one of them.
The purpose of this study was to evaluate if patients with endometriosis had a higher risk of contracting COVID‐19 infection and, in such case, whether they developed a more severe infection than the general population. Furthermore, this study evaluated the possible correlation with the stage of endometriosis, based on the r‐ASRM score, and the potential worsening of the disease during the SARS‐CoV‐2 infection.
Method of study
A case‐control study was conducted from March 2020 to April 2021 at Macedonio Melloni Hospital, in Milan. A total of 401 women were recruited. The cases were 201 women with clinical or surgical diagnosis of endometriosis. The control group consisted of 200 women, without the disease. All women completed a self‐administered questionnaire which evaluated their demographic and clinical characteristics, as well as a potential diagnosis of Covid‐19.
Results
Comparison between the two groups showed that women with endometriosis had a higher frequency of COVID‐19 than the control subjects (23% vs. 13.5%,
P
= .014), with a greater prevalence of fever (14.4% vs. 6%,
P
= .008) and myalgias or arthralgias (11.4% vs. 4.5%,
P
= .01).
In multivariable logistic regression analyses, women with endometriosis had a higher risk of contracting SARS‐CoV‐2 infection (OR = 2.11, 95% IC: 1.20–3.80), regardless the stage of the disease.
Conclusion
Endometriosis increases the susceptibility to COVID‐19, and women who suffer from it should be considered as fragile patients, worthy of prior access to SARS‐CoV‐2 vaccination campaign.
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