RESUMO
Background: The impact of Covid-19 on endometriosis patients is under-researched. Endometriosis has significant psychosocial effects on patients. Moreover, the mainstay of diagnosis and treatment of endometriosis is elective surgery, impacted as a result of healthcare strain. Objective: To better understand the effect of the Covid-19 pandemic on endometriosis patients. Materials and Methods: An online survey sent to adult UK endometriosis patients between 27th August and 15th September 2021. The study received HRA and HCRW research ethic committee approval. Main outcome measures: Effects of the Covid-19 pandemic on endometriosis symptoms and surgery. Results: We received 1,089 survey responses. Respondents had a median age of 34, and 82.0% of respondents were white British. 18.8% of respondents reported a previous positive Covid-19 PCR test. 84.6% of patients had been double vaccinated at time of response. 20 patients reported Covid-related hospital admission, with 1 requiring intubation. Large numbers of patients (31.4-55.2%) reported worsening of endometriosis symptoms during the pandemic. 69.2% of respondents reported worsening of associated mental health symptoms. Whilst 44% of respondents had elective endometriosis surgery planned, the majority of operations were disrupted, and 18.7% of total respondents did not have a new surgery date. Conclusions: More research and support are needed for endometriosis patients as they wait longer for surgery. A holistic approach, encompassing mental health needs, may be particularly beneficial for patients. What is new?: This is the first survey examining the effects of Covid-19 on endometriosis patients including data beyond January 2021.
RESUMO
Inflammation and neurodegeneration are key features of many chronic neurological diseases, yet the causative mechanisms underlying these processes are poorly understood. There has been mounting interest in the role of the human microbiome in modulating the inflammatory milieu of the central nervous system (CNS) in health and disease. To date, most research has focussed on a gut-brain axis, with other mucosal surfaces being relatively neglected. We herein take the novel approach of comprehensively reviewing the roles of the microbiome across several key mucosal interfaces - the nose, mouth, lung and gut - in health and in Parkinson's disease (PD), Alzheimer's disease (AD) and multiple sclerosis (MS). This review systematically appraises the anatomical and microbiological landscape of each mucosal surface in health and disease before considering relevant mechanisms that may influence the initiation and progression of PD, AD and MS. The cumulative effects of dysbiosis from the nose to the gut may contribute significantly to neurological disease through a wide variety of mechanisms, including direct translocation of bacteria and their products, and modulation of systemic or CNS-specific immunity. This remains an understudied and exciting area for future research and may lead to the development of therapeutic targets for chronic neurological disease.
