EFFECT OF HORMONAL CONTRACEPTION ON ILLNESS SEVERITY IN WOMEN WITH POSITIVE SARS-CoV2 TESTS

Abstract

To evaluate if hormonal contraception affects illness severity in SARS-CoV2 positive women. Retrospective cohort study. Chart review of reproductive age (12-49 yo) women who tested positive for SARS-CoV2 at a tertiary medical center from March 28-April 27, 2020. Exclusion criterion was pregnancy. Women using hormonal contraception were compared to patients not using hormonal contraception. Patients were not contacted to confirm contraception. The primary outcome was hospital admission rate. Secondary outcomes included a composite score for illness severity and clinical signs of infection (Table 1). Multivariable logistic regression was used to control for differences at baseline. Results are reported as adjusted odds ratio (aOR) with a 95% confidence interval (CI). Calculated p values < 0.05 were statistically significant. A total of 2044 women were screened for SARS-CoV2. Of the 132 positive women, 46 used hormonal contraception: levonorgestrel IUD (n=9; 19.6%), injectable progestin (n=2; 4.35%), oral progestin (n=3; 6.52%), oral contraceptive (n= 24; 52.1%), transdermal patch (n=4; 8.70%), vaginal ring (n=4; 8.70%) and 86 did not use hormonal contraception. The rate of hospitalization for SARS-CoV2 was low for users and non-users of hormonal contraception (2.3% vs. 3.8%, respectively) and was not statistically different between groups. There was no difference between the rate of symptoms and clinical signs of infection between groups. Sex hormones may play a significant role in regulating immune response and can impact disease state. We provide preliminary evidence that use of hormonal contraception does not have a significant effect on the illness severity in SARS-CoV2 as measured by hospitalization.Table 1Primary and secondary outcomesHormonal contraception (n= 44)aNot on hormonal contraception (n=79)aAdjusted OR (95% CI)Primary OutcomeHospital admission1 (2.3)3 (3.8)0.99 (0.68-1.44)Clinical SignsComposite score of illness severityb1 (2.3)2 (2.5)0.98 (0.67-1.43)Heart rate > 100 beats/min4 (9.1)3 (3.8)0.99 (0.68-1.45)Respiratory rate > 22 breaths/min1 (2.3)1 (1.3)0.97 (0.67-1.42)Urine output < 0.5 mL/kg/hr1 (2.3)1 (1.3)0.97 (0.66-1.42)Lactate > 3 mmol/L00cTemperature > 100.4 °F6 (13.6)8 (10.1)0.98 (0.67-1.42)WBC > 12,000 or < 4,000 / mmˆ300cIntubation00cData are shown as n/N (%) unless otherwise specified a n=2 & n=7 patients excluded in the hormonal vs. not hormonal groups, respectively, due to no data on hospital admission b Components of the composite: hypoxia (O2 < 94%), > than 50% lung involvement on imaging, respiratory failure, respiratory shock, multiorgan dysfunction, death c Unable to perform logistic regression due to cells with 0 counts Open table in a new tab