POST-COVID-19-syndrome in young healthy women: myth or reality?

Aim. To assess the incidence and severity of new persistent symptoms in somatically healthy young women with and without a history of COVID-19.

Materials and methods. The main study group included patients who had PCR-confirmed COVID-19 in July–October 2021 (n=181); the comparison group included women without COVID-19 during this period (n=71). Inclusion criteria: female sex, age 18–35 years, no pregnancy, overweight/obesity, diabetes mellitus, chronic hypertension, premenstrual syndrome, and other somatic and/or chronic infectious diseases. Post-COVID syndrome (PCS) was diagnosed based on symptoms absent before COVID-19, appeared >4 weeks from the disease onset, and lasted at least 2 months, which could not be explained by alternative diagnoses. We used primary medical records and interviewed patients using a special questionnaire to develop a statistical database. The severity of symptoms was assessed using a 10-point scale.

Results. New persistent symptoms during the pandemic in young, initially somatically healthy women with and without COVID-19 were reported with similar frequency: 96.1 and 93.0%, respectively (odds ratio – OR 1.88, 95% confidence interval – CI 0.58–6.14; pχ²=0.327). Only patients with COVID-19 reported cough (43.6%), shortness of breath (26.5%), chest pain (18.2%), weight loss (18.8%), hair loss (60.8%); in the comparison group, these symptoms were not reported; pχ²<0.001. Patients with PCS were more likely to experience memory impairment – 49.2% vs 12.7% (OR 6.66, 95% CI 3.13–14.21; pχ²<0.001); headache – 43.1% vs 11.3% (OR 5.96, 95% CI 2.7–13.17; pχ²<0.001); depression – 19.9% vs 8.5% (OR 2.69, 95% CI 1.08–6.7; pχ²=0.029); myalgia – 31.5% vs 8.5% (OR 4.98, 95% CI 2.04–12.17; pχ²<0.001). Patients of both groups showed similar frequency of fatigue (69.0% vs 71.8%; pχ²=0.66), drowsiness (54.9% vs 43.6%; pχ²=0.11), palpitations (19.7% vs 29.8%; pχ²=0.1), menstrual cycle changes (22.5% vs 21.0%; pχ²=0.865), and skin manifestations (2.8% vs 6.6%; pχ²=0.24). COVID-19 survivors had a more pronounced memory impairment (4.0 vs 1.0 points; p<0.001), headache (5.0 vs 3.0 points; p=0.001), myalgia (5.0 vs 1.0 points; p<0.001) and less severe insomnia (3.0 vs 5.0 points; p=0.004).

Conclusion. The PCS symptoms are common in initially somatically healthy women of early reproductive age. Similar symptoms in women with no history of COVID-19 may be due to post-traumatic stress anxiety disorder. Further interdisciplinary research is needed to identify the pathophysiological mechanisms for the occurrence of new persistent symptoms in different age and social groups during the COVID-19 pandemic.