COVID-19 pandemic and the consequential effect on patients with endometriosis
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Abstract
STUDY QUESTION
What was the effect of the coronavirus disease 2019 (COVID-19) pandemic on healthcare and quality of life in those suffering from endometriosis?
SUMMARY ANSWER
Our study reveals a clear correlation between the deterioration of the reported physical and mental state and impaired medical care for patients suffering from endometriosis during the COVID-19 pandemic.
WHAT IS KNOWN ALREADY
The quality of life of patients suffering from endometriosis is compromised in a variety of aspects. In response to the ongoing COVID-19 pandemic, self-isolation practices aimed at curbing the spread of COVID-19 have severely complicated the availability of proper medical care worldwide.
STUDY DESIGN, SIZE, DURATION
The study involved a cross-sectional international self-reported online survey. Responses were accepted between November 2020 and January 2021. The survey was prepared by the Department of Obstetrics and Gynaecology in a medical university setting. The survey contained 17 questions and was placed online. Cooperation with different endometriosis organizations around the world enabled distribution of the survey through their social media platforms.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The study participants (n = 3024 replies) originated from 59 countries. The questionnaire was created after a literature review and is partially based on the validated quality of life questionnaires, adjusted to the study question. The survey was then translated to 15 other languages following World Health Organization recommendations as closely as possible. Chi-square tests for independence were carried out for the analysis of the two variables: suspension of health services, and the patients mental and physical well-being.
MAIN RESULTS AND THE ROLE OF CHANCE
Out of 3024 participants from 59 countries who submitted the questionnaire between November 2020 and January 2021, 2964 (98.01%) provided information that enabled a full analysis. For the 1174 participants who had their medical appointments cancelled, 43.7% (n = 513) reported that their symptoms had been aggravated, and 49.3% (n = 579) reported that their mental state had worsened.
In comparison, of the 1180 participants who kept their appointments, only 29.4% (n = 347) stated that their symptoms had been aggravated, and 27.5% (n = 325) stated their mental health had worsened. The results showed that there was a significant link between the reported deterioration of mental and physical wellbeing and impaired medical care (cancellation) (P ≪ 0.001). A total of 610 participants did not have medical appointments scheduled, and these participants followed a similar pattern as the participants who kept their appointments, with 29.0% (n = 177) reporting aggravation of symptoms and 28.2% (n = 172) reporting that their mental state had worsened.
LIMITATIONS, REASONS FOR CAUTION
Cultural differences among international participants are to be expected and this may have affected how participants from different countries interpreted and answered the questionnaire. Translating the questionnaire into 15 different languages, even though incorporating backwards translation, could possibly lead to different interpretations of given questions, simply based on different wording in the languages. The majority of respondents (around 90%) were from Europe and South America and therefore the findings may not be generalizable to other locations.
WIDER IMPLICATIONS OF THE FINDINGS
Further research is needed to assess the true impact and long-term consequences of the COVID-19 pandemic for patients living with endometriosis.
STUDY FUNDING/COMPETING INTEREST(S)
This study received no funding and the authors declare they have no relevant conflicts of interest.
TRIAL REGISTRATION NUMBER
N/A.
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SciScore for 10.1101/2021.05.04.21255000: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Ethical approval: The bioethics committee of the Pomeranian Medical University in Szczecin provided an exemption from an ethical consent-case number: KB-0012/34/03/2021/Z. Sex as a biological variable The second section of the questionnaire was based on a review of EHP-30 (Khong et al., 2010), a validated tool designed to measure the health-related quality of life (HRQoL) in women with endometriosis (Bourdel et al., 2019; Moradi et al., 2019; Weeks, 2020). Randomization The literature review included comparative studies, qualitative studies, clinical trials, controlled and randomized controlled trials, and multicenter studies. Blinding not detected. Power Analysis not detected. Table 2: …
SciScore for 10.1101/2021.05.04.21255000: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Ethical approval: The bioethics committee of the Pomeranian Medical University in Szczecin provided an exemption from an ethical consent-case number: KB-0012/34/03/2021/Z. Sex as a biological variable The second section of the questionnaire was based on a review of EHP-30 (Khong et al., 2010), a validated tool designed to measure the health-related quality of life (HRQoL) in women with endometriosis (Bourdel et al., 2019; Moradi et al., 2019; Weeks, 2020). Randomization The literature review included comparative studies, qualitative studies, clinical trials, controlled and randomized controlled trials, and multicenter studies. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations of the study: Due to a low number of SARS-CoV-2 positive respondents, any test of association would be underpowered, and we are therefore unable to say whether there is a significant connection or not. With an international questionnaire, arising issues of cultural differences and subjective answers are likely inevitable. In most cases, the research team ensured that at least two people who spoke the target language were translating the survey from English to the target language, but could not always ensure that two translators whose mother tongue was English were also both fluent in the target language. Further limitations with a multiple-choice questionnaire are that participants can allude to different meanings when selecting the same answer. This problem increases when trying to reach an international sample of people. Furthermore, the questionnaire was anonymous, and we have no confirmation of whether the participants are indeed real and whether they answered honestly, although there is little reason to suspect otherwise, given that there was no incentive to take this questionnaire. Distribution of the survey online, through various platforms and with the help of national and international endometriosis organizations, resulted in varying levels of success, and in some countries, we did not manage to release the questionnaire at all. Europe and South America are more represented than other areas, with around 90% of the respondents residing in these continents....
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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