key: cord-0704739-qym80ck2
authors: Khan, Sana M.; Shilen, Alexandra; Heslin, Kelly M.; Ishimwe, Providence; Allen, Alicia M.; Jacobs, Elizabeth T.; Farland, Leslie V.
title: SARS-CoV-2 infection and subsequent changes in the menstrual cycle among participants in the Arizona CoVHORT Study
date: 2021-09-20
journal: Am J Obstet Gynecol
DOI: 10.1016/j.ajog.2021.09.016
sha: 5d74566759c307a0f8d28d7c1adc559a597b4fe4
doc_id: 704739
cord_uid: qym80ck2

nan

1 Objective: The menstrual cycle involves complex interactions between various tissues, hormones, and 40 organ systems. As such, the menstrual cycle is sensitive to endogenous and exogenous factors, including 41 infection and changes in lifestyle. Over a year into the global pandemic caused by SARS-CoV-2 42 (COVID-19), there is increasing interest in understanding the post-acute sequalae of SARS-CoV-2 43 (PASC) following infection (1) . Emerging evidence suggests that SARS-CoV-2 infection (2), COVID-44 19 vaccination, and/or psychological stress related to the COVID-19 pandemic (3) may influence the 45 menstrual cycle. However, there is a paucity of scientific research on these topics; therefore, our 46 objective was to describe SARS-CoV-2 infection and menstrual cycle changes. 47

Study Design: In May 2020, the Arizona CoVHORT Study began recruiting individuals for a 48 prospective, population-based cohort, with the purpose of identifying the long-term consequences of 49 COVID-19. The design of CoVHORT has been previously published (4); briefly, SARS-CoV-2 positive 50 cases were recruited through case investigations as part of an academic-health department partnership 51 with several health departments and testing centers across Arizona. We restricted our analysis to SARS-52

CoV-2 positive participants, 18-45 years old, who identified as women or non-binary and who were not 53 currently or recently pregnant as of January 2020. Participants reporting laboratory-confirmed or 54 suspected SARS-CoV-2 infection were administered "symptom surveys" focused on COVID-19 55 symptomology at approximately 6-week intervals. All study procedures were approved by the 56 Min-max 1-9 1-10 PSS-10 (baseline) 5 

Have you been tested for the virus that causes CoVID19 with a nasal swab, throat swab or saliva? Or "Were you told by a medical provider that you were

Prefer not to answer": self-rated severity score (n=1)

Missing values: race (n=1), ethnicity (n=4), severity score (n=18), PSS-10 baseline (n=24)

PSS-10 frames questions

(select all that apply: fever, sore throat, cough, difficulty breathing or shortness of breath, chest pain or pressure, runny nose/cold-like symptoms, fatigue, aches and pains or muscle sores, chills, diarrhea (3 or more loose/looser than normal stools/24 hr period), nausea, vomiting, headache, loss of smell/taste, bone pain/nerve pain, conjunctivitis, rash on skin

We thank our Arizona CoVHORT participants for sharing their experiences with