Estrogen and COVID-19 symptoms: Associations in women from the COVID Symptom Study

Costeira, Ricardo; Lee, Karla A.; Murray, Benjamin; Christiansen, Colette; Castillo-Fernandez, Juan; Lochlainn, Mary Ní; Pujol, Joan Capdevila; Macfarlane, Heather; Kenny, Louise C.; Buchan, Iain; Wolf, Jonathan; Rymer, Janice; Ourselin, Sébastien; Steves, Claire J.; Spector, Timothy D.; Newson, Louise; Bell, Jordana T.

doi:10.1371/journal.pone.0257051

Cited by 77 publications

(95 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is consistent with the recent suggestion that an “inflammatory” rather than an “ovulatory” route might explain menstrual disturbances following COVID-19 vaccination given the high prevalence of breakthrough bleeding among users of long-acting reversible contraceptives (LARC) [8]. A protective effect of oestrogen [33] and oestradiol [34] has been suggested in relation to the severity of COVID-19, and randomized control trials on unbiased samples would be needed to establish causality between oestrogen and the reduced risk of menstrual disturbances following COVID-19 vaccination. Finally, the diversity of menstrual responses to COVID-19 vaccination might be partly explained by the timing of vaccination in relation to the menstrual cycle.…”

Section: Discussionsupporting

confidence: 88%

COVID-19 vaccination and menstrual cycle changes: A United Kingdom (UK) retrospective case-control study

Alvergne

Kountourides²,

Argentieri

et al. 2021

Preprint

View full text Add to dashboard Cite

Background. There has been increasing public concern that COVID-19 vaccines cause menstrual cycle disturbances, yet there is currently limited data to evaluate the impact of vaccination on menstrual health. Our objectives were (1) to evaluate the prevalence of menstrual changes following vaccination against COVID-19, (2) to test potential risk factors for any such changes, and (3) to identify patterns of symptoms in participants' written accounts. Methods. We performed a secondary analysis of a retrospective online survey titled The Covid-19 Pandemic and Women's Reproductive Health, conducted in March 2021 in the UK before widespread media attention regarding potential impacts of SARS-CoV-2 vaccination on menstruation. Participants were recruited via a Facebook ad campaign in the UK and eligibility criteria for survey completion were age greater than 18 years, having ever menstruated and currently living in the UK. In total, 26,710 people gave consent and completed the survey. For this analysis we selected 4,989 participants who were pre-menopausal and vaccinated. These participants were aged 28 to 43, predominantly from England (81%), of white background (95%) and not using hormonal contraception (58%). Findings. Among pre-menopausal vaccinated individuals (n=4,989), 80% did not report any menstrual cycle changes up to 4 months after their first COVID-19 vaccine injection. Current use of combined oral contraceptives was associated with lower odds of reporting any changes by 48% (OR = 0.52, 95CI = [0.34 to 0.78], P<0.001). Odds of reporting any menstrual changes were increased by 44% for current smokers (OR = 1.44, 95CI = [1.07 to 1.94], P<0.01) and by more than 50% for individuals with a positive COVID status [Long Covid (OR = 1.61, 95CI = [1.28 to 2.02], P<0.001), acute COVID (OR = 1.54, 95CI = [1.27 to 1.86], P<0.001)]. The effects remain after adjusting for self-reported magnitude of menstrual cycle changes over the year preceding the survey. Written accounts report diverse symptoms; the most common words include 'cramps', 'late', 'early', 'spotting', 'heavy' and 'irregular', with a low level of clustering among them. Conclusions. Following vaccination for COVID-19, menstrual disturbance occurred in 20% of individuals in a UK sample. Out of 33 variables investigated, smoking and a previous history of SARS-CoV-2 infection were found to be risk factors while using oestradiol-containing contraceptives was found to be a protective factor. Diverse experiences were reported, from menstrual bleeding cessation to heavy menstrual bleeding.

show abstract

Section: Discussionsupporting

confidence: 88%

COVID-19 vaccination and menstrual cycle changes: A United Kingdom (UK) retrospective case-control study

Alvergne

Kountourides²,

Argentieri

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…ExeTera has been a key part in enabling analysis of the Covid Symptom Study dataset, including being used for analysis in the following manuscripts [13][14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

Accessible Data Curation and Analytics for International-Scale Citizen Science Datasets

Murray¹,

Kerfoot²,

Graham³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

The Covid Symptom Study, a smartphone-based surveillance study on COVID-19 symptoms in the population, is an exemplar of big data citizen science. Over 4.7 million participants and 189 million unique assessments have been logged since its introduction in March 2020. The success of the Covid Symptom Study creates technical challenges around effective data curation for two reasons. Firstly, the scale of the dataset means that it can no longer be easily processed using standard software on commodity hardware. Secondly, the size of the research group means that replicability and consistency of key analytics used across multiple publications becomes an issue. We present ExeTera, an open source data curation software designed to address scalability challenges and to enable reproducible research across an international research group for datasets such as the Covid Symptom Study dataset.

show abstract

“…Premenopausal women had lower rates and short duration of hospitalization along with less requirement for respiratory support compared to post-menopausal women [ 39 ]. Moreover, a direct correlation between COVID-19 and menopausal condition and an inverse association with combined oral contraceptive pill use have been reported [ 40 ].…”

Section: Sex and Gender Factors In Covid-19 Infection And Outcomementioning

confidence: 99%

Sex-Related Factors in Cardiovascular Complications Associated to COVID-19

et al. 2021

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19), the pandemic infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents with an extremely heterogeneous spectrum of symptoms and signs. The clinical manifestations seem to be correlated with disease severity. COVID-19 susceptibility and mortality show a significant sex imbalance, with men being more prone to infection and showing a higher rate of hospitalization and mortality compared to women. Such variability can be ascribed to both sex-related biological factors and gender-related behavioral cues. This review will discuss the potential mechanisms accounting for sex/gender influence in vulnerability to COVID-19. Cardiovascular diseases play a central role in determining COVID-19 outcome, whether they are pre-existent or arose upon infection. We will pay particular attention to the impact of sex and gender on cardiovascular manifestations related to COVID-19. Finally, we will discuss the sex-dependent variability in some biomarkers for the evaluation of COVID-19 infection and prognosis. The aim of this work is to highlight the significance of gendered medicine in setting up personalized programs for COVID-19 prevention, clinical evaluation and treatment.

show abstract

Estrogen and COVID-19 symptoms: Associations in women from the COVID Symptom Study

Cited by 77 publications

References 46 publications

COVID-19 vaccination and menstrual cycle changes: A United Kingdom (UK) retrospective case-control study

COVID-19 vaccination and menstrual cycle changes: A United Kingdom (UK) retrospective case-control study

Accessible Data Curation and Analytics for International-Scale Citizen Science Datasets

Sex-Related Factors in Cardiovascular Complications Associated to COVID-19

Contact Info

Product

Resources

About