Журнал "Гастроэнтерология" Том 60, №2, 2026

Актуальність. Жінки з ендометріозом можуть мати підвищений ризик тривалого COVID-19, однак клінічні дані щодо персистенції гастроінтестинальних симптомів після COVID-19 у цієї групи обмежені, що ускладнює післяінфекційне ведення та планування спостереження. Мета дослідження: оцінити гострі та тривалі шлунково-кишкові прояви COVID-19 у жінок з ендометріозом порівняно з контрольною групою, а також визначити фактори ризику розвитку тривалого COVID-19 зі стійкими гастроінтестинальними симптомами. Матеріали та методи. Проведено проспективне обсерваційне когортне дослідження за участю 100 жінок віком 18–45 років: 50 з хірургічно підтвердженим або клінічно верифікованим ендометріозом та 50 без ендометріозу, підібраних за віком. Усі учасниці перенесли лабораторно підтверджену інфекцію SARS-CoV-2 протягом останніх шести місяців. Оцінювали гострі й персистуючі шлунково-кишкові симптоми (GSRS), гінекологічні прояви, психічний стан (HADS). Повторні оцінки здійснювали через 3 та 6 місяців. Результати. Жінки з ендометріозом мали істотно вищу частоту гострих гастроінтестинальних симптомів під час COVID-19 (76,6 проти 62,4 %; p = 0,013), зокрема здуття живота (56,3 проти 36,0 %) та болю в животі (45,3 проти 25,6 %). Через три місяці після інфікування тривалий COVID-19 спостерігався у 42,2 % жінок з ендометріозом порівняно з 25,6 % у контрольній групі (RR = 1,65; p = 0,005), а персистуючі шлунково-кишкові симптоми — у 35,2 проти 17,6 % відповідно (p = 0,001). Також у групі ендометріозу частіше фіксували погіршення дисменореї (27,3 проти 9,6 %) та тазового болю (21,9 проти 6,4 %). У багатофакторній логістичній моделі ендометріоз залишався незалежним предиктором тривалого COVID-19 із гастроінтестинальними симптомами (OR = 2,12; p < 0,01) поряд з наявністю синдрому подразненого кишечника, ≥ 3 гострими шлунково-кишковими симптомами, тривогою та депресією, тоді як вакцинація мала захисний ефект (OR = 0,78; p = 0,035). Висновки. Отримані результати свідчать, що ендометріоз значно підвищує ризик як гострих, так і тривалих шлунково-кишкових ускладнень після COVID-19. Необхідні цілеспрямовані стратегії моніторингу та профілактики, включно з вакцинацією та раннім виявленням стійких симптомів.

Background. Women with endometriosis may be at increased risk of long COVID-19; however, clinical data on the persistence of gastrointestinal symptoms after COVID-19 in this group are limited, complicating post-infection management and follow-up planning. The purpose of the study was to assess acute and prolonged gastrointestinal manifestations of COVID-19 in women with endometriosis compared to the control group, as well as to determine risk factors for the development of long COVID-19 with persistent gastrointestinal symptoms. Materials and methods. A prospective observational cohort study was conducted with the participation of 100 women aged 18–45 years: 50 with surgically confirmed or clinically verified endometriosis and 50 without endometriosis, selected by age. All participants had a laboratory-confirmed SARS-CoV-2 infection within the past six months. Acute and persistent gastrointestinal symptoms (according to the Gastrointestinal Symptom Rating Scale), gynecological manifestations, mental status (according to the Hospital Anxiety and Depression Scale) were assessed. Repeated tests were carried out after 3 and 6 months. Results. Women with endometriosis had a significantly higher incidence of acute gastrointestinal symptoms during COVID-19 (76.6 vs. 62.4 %; p = 0.013), including bloating (56.3 vs. 36.0 %) and abdominal pain (45.3 vs. 25.6 %). Three months after infection, long COVID-19 was observed in 42.2 % of women with endometriosis compared to 25.6 % in the control group (RR = 1.65; p = 0.005), and persistent gastrointestinal symptoms were detected in 35.2 vs. 17.6 %, respectively (p = 0.001). Also, in the endometriosis group, worsening of dysmenorrhea (27.3 vs. 9.6 %) and pelvic pain (21.9 vs. 6.4 %) were more often recorded. In the multivariate logistic model, endometriosis remained an independent predictor of long COVID-19 with gastrointestinal symptoms (OR = 2.12; p < 0.01), along with the presence of irritable bowel syndrome, ≥ 3 acute gastrointestinal symptoms, anxiety, and depression, while vaccination had a protective effect (OR = 0.78; p = 0.035). Conclusions. The findings show that endometriosis significantly increases the risk of both acute and long-term gastrointestinal complications after COVID-19. Targeted monitoring and prevention strategies are needed, including vaccination and early detection of persistent symptoms.

ендометріоз; тривалий COVID-19; шлунково-кишкові симптоми; вегетативна дисфункція; запалення; тазовий біль; жіноче здоров’я

endometriosis; long COVID-19; gastrointestinal symptoms; autonomic dysfunction; inflammation; pelvic pain; women’s health

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