Earlier in the COVID-19 pandemic, some women reported menstrual periods that arrived early or late or spotting between periods, and now a study published yesterday in BMC Infectious Diseases has confirmed those reports.

Abnormal uterine bleeding (AUB) was “reported by nearly half of women, regardless of HIV status,” wrote the authors, led by researchers at the University of Miami. “This AUB prevalence is higher than has previously been reported before the pandemic… which is especially notable because we excluded women who had many known causes of AUB.” 

Role of COVID-19, stress

Researchers examined data from 188 women ages 18 to 45 who lived in the southern United States and didn’t have conditions that affect uterine bleeding (eg, polyendocrine metabolic ovarian syndrome (PMOS), endometriosis) to understand how COVID contributed to AUB. 

The women, 61% of whom had HIV, were in the Study of Treatment and Reproductive Outcomes (STAR). They answered questions about COVID-19 testing and vaccination, changes to their periods, stress, and demographic information. 

This AUB prevalence is higher than has previously been reported before the pandemic… which is especially notable because we excluded women who had many known causes of AUB.

Of the women, 69% had a previous COVID-19 infection. AUB occurred more often in COVID-19 survivors who didn’t have HIV. Those who experienced more stress also had higher rates of AUB, although unusual bleeding occurred even in women who never had COVID-19. 

“Our study was conducted during the COVID-19 pandemic, when women may have been paying greater attention to menstrual patterns due to reports of AUB in the media, and women may have experienced other factors that could impact psychosocial factors, such as stress and AUB, such as food insecurity or sleep disruptions,” the authors wrote. 

The changes in uterine bleeding weren’t considered harmful, but the study’s findings may mean that another novel viral infection could also affect menstrual patterns, they added. 

A fifth person has died from Legionnaires’ disease in an outbreak in Manhattan, New York officials said late last night. 

The outbreak has been connected to bacteria found in cooling towers on the Upper East Side. So far, 82 cases of Legionnaires’ disease have been identified, and eight people remain hospitalized. Fifty-six people have been discharged from the hospital, and 13 were never hospitalized. 

Officials have tested 183 cooling towers at 160 buildings, and 77 cooling towers were positive for Legionella bacteria. 

“Legionnaires' disease is not caused by any building's plumbing system,” NYC Health said. “Residents in ZIP codes 10028, 10128, and 10075 can continue to drink tap water, bathe, shower, cook, and use your air conditioner at home.”

About 10% of people with Legionnaires’ disease die from their infections. Early treatment with antibiotics can help limit disease severity.

More than a year after COVID-19 symptom onset, both previously hospitalized and nonhospitalized women who had long COVID reported four neurologic symptoms more often than their male peers, Northwestern University researchers write.

For the study, published yesterday in the Annals of Clinical and Translational Neurology, the authors analyzed 261 hospitalized patients (PNP) and 2,068 nonhospitalized patients (NNP) who visited a long-COVID clinic from May 2020 to August 2025.

“While it has long been known that PASC [post-acute sequelae of SARS-CoV-2, or long COVID] more frequently affects women than men, whether an association exists between sex and Neuro-PASC has not been determined in detail,” they wrote. 

More-severe fatigue, less ability to focus

An average of 16 months after COVID symptoms began, women in both groups reported four neurologic symptoms more often than men (PNP, 79.6% vs 64.9%; NNP, 76.1% vs 64.6%). Both female PNPs and NNPs more often cited numbness/tingling, dizziness, headache, and pain than men, but only female NNPs reported brain fog, muscle pain, and impaired sense of taste and smell more often than male NNPs.

Females suffer from a higher symptom burden of Neuro-PASC and had worse subjective quality of life and objective cognitive function.

Women in both groups also more frequently reported fatigue, shortness of breath, chest pain, and dysautonomia (a nervous system disorder) than men, while only female NNPs cited more frequent gastrointestinal symptoms than male NNPs. 

Relative to men, women from both groups indicated worse fatigue on the Patient-Reported Outcome Measure Information System questionnaire, and female NNPs performed worse on a task of attention on the National Institutes of Health Toolbox cognitive test.

“Females suffer from a higher symptom burden of Neuro-PASC and had worse subjective quality of life and objective cognitive function,” the researchers wrote. “These results highlight the importance of timely diagnosis and targeted interventions in female patients who are often negatively affected by gender bias in medicine.”