The long-term oncopathology effects of COVID-19 infection and
vaccination on the female reproductive system
Abstract
Background: Since the COVID-19 pandemic started in 2019, has resulted in
various health conditions, including adverse effects on different
systems. The female reproductive system (FRS) is known to be one of the
organs affected by the virus or the vaccination due to its high
expression of the ACE 2 receptor, which is one of the primary receptors
of COVID-19 that facilitates its entry into the cells. This review
assessed the impact of COVID-19 infection and vaccination on the female
reproductive system and their relationship with endometrial, ovarian,
cervical, and vulvar cancers. Recent findings: COVID-19 virus may
elevate pro-inflammatory factors, such as TNF-α, IL-6, interleukin-1β
(IL-1β), and interferon-gamma (IFN-γ), during both the acute and
recovery phases of infection. COVID-19 infection can heighten the
inflammatory response and cell susceptibility by downregulating the
ACE-2 receptor. Additionally, COVID-19 influences the female
reproductive system by altering the epithelial-mesenchymal tissue
microenvironment and disrupting blood vessels and endothelial cells.
However, studies fail to acknowledge the potential impact of vaccination
on FRS. Conclusion: Given the pivotal roles of the TMPRSS2 enzyme and
ACE2 receptor in the pathogenic mechanism of the coronavirus, it is
suggested that cells expressing higher levels of these enzymes and
receptors may be more prone to endometrial cancer development. Notably,
the cytokine storm and ACE/ACE2 pathway imbalance increase the risk of
ovarian cancer. Cervical cells have a low expression of the ACE2
receptor, reducing the likelihood of infection in intraepithelial
cervical cells and cervical cancer. Although coronavirus infection and
its immunization can lead to vulvar aphthous ulcers, limited research
investigates the link between COVID-19 infection, immunization, and
vulvar cancer.