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

Alexandre Vallée, Maxence Arutkin, Pierre‐François Ceccaldi, Pierre-François Ceccaldi, Anis Feki, Anis Féki, Jean-Marc Ayoubi
BMC women's health · 2025 · vol. 25(1) , pp. 229 · doi:10.1186/s12905-025-03761-9 · PMID:40375203 · PMC12079877 · W4410417028
review OA: gold CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review and meta-analysis found an association between endometriosis and long COVID, with a pooled relative risk of 1.41 in endometriosis patients compared to non-endometriosis patients.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review and meta-analysis assessed the association between endometriosis and long COVID (symptoms persisting for at least 8 weeks after SARS-CoV-2 infection) by searching PubMed/Medline, Cochrane Library, and ScienceDirect for studies published up to August 2023. Two observational studies (216,095 participants) from US nurse and general female cohorts compared endometriosis vs non-endometriosis status and reported adjusted measures of long COVID risk. The pooled random-effects analysis found long COVID was more common in endometriosis patients (16.2% vs 10%), with a pooled risk ratio of 1.41 (95% CI 1.31–1.52) and low heterogeneity (I²=29%); however, the authors note the evidence is limited to two nonrandomized studies, and publication-bias assessment is underpowered. This paper is centrally about endometriosis — it systematically reviews and meta-analyzes studies linking endometriosis to increased long COVID risk.

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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.

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Outcome instruments

rASRM

Condition tags

endometriosisinfertility

MeSH descriptors

COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19 COVID-19

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (82)

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europepmc
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