Last July, when her immediate family tested positive for Covid-19, Breanna Aguilar did not fit into any groups considered at higher risk for severe disease.

She is 31 years old, a pet sitter and former fitness teacher who once ran a half marathon. She was, by most measures, healthy.
When Aguilar got Covid-19 she lost her sense of taste, had mild fevers and muscle weakness. She could barely keep anything down yet gained about 30 pounds. Later, she developed pelvic pain, cystic acne, breast tenderness, headaches, brain fog and extreme fatigue.
It has been months since then, but she says the low energy, chronic pain and brain fog — long-haul Covid-19 symptoms — remain and she can’t even go for a 15-minute walk without needing a break. She’s also now dealing with insulin resistance and taking several medications to keep that and her hormone levels under some control. Her doctor told her she’ll likely be dealing with this fallout of Covid-19 for the rest of her life.
More than a year into the pandemic, one study has found that some women are at higher risk for Covid-19 compared to others in their age and sex groups. These women, often young and otherwise healthy like Aguilar, have an underlying condition that isn’t mentioned on any Covid-19 comorbidity list: polycystic ovary syndrome, or PCOS.
PCOS, which affect about 1 in 10 women of “childbearing age,” is an imbalance of reproductive hormones that can lead to irregular menstrual cycles, high androgen levels and ovarian cysts. But it can also come with a host of other health problems, nearly all of which overlap Covid-19 comorbidities.
“PCOS is completely underestimated in its impact. It’s sort of seen as some reproductive issue that is not clinically relevant. But this is completely wrong … Patients need to be seen as a high-risk population,” said Dr. Wiebke Arlt, director of the Institute of Metabolism and Systems Research at the University of Birmingham in the United Kingdom.
More than half of people with PCOS develop diabetes before their 40th birthdays, and up to 80% are overweight. They have higher risk of insulin resistance, heart disease and endometrial cancer, a cancer that begins in the uterus. Many have high blood pressure and low levels of vitamin D. These complications of PCOS have also been associated with a potentially higher risk for severe Covid-19.
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