Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and COVID-19: is there a connection?
AlMuhaissen, Suha, Abu Libdeh, Amal, ElKhatib, Yara et al. · Current medical research and opinion · 2023 · DOI
Quick Summary
This study looked at whether people who had COVID-19 might develop ME/CFS afterward. Researchers asked 437 people who had COVID-19 questions based on the official diagnostic criteria for ME/CFS. They found that about 8% of COVID-19 patients met the criteria for ME/CFS, suggesting there may be a connection between the two illnesses.
Why It Matters
This research provides epidemiological evidence that ME/CFS may develop following COVID-19 infection, which is important for clinicians to recognize post-COVID symptoms that warrant ME/CFS evaluation. The finding supports the need for follow-up care protocols for COVID-19 patients and validates concerns from both ME/CFS and long COVID communities about overlapping pathophysiology.
Observed Findings
8.1% of COVID-19 patients met IOM diagnostic criteria for ME/CFS
2.8% were classified as having COVID-19-related ME/CFS
4.6% had disease-related fatigue without meeting full ME/CFS criteria
Almost 25% (approximately) reported a family history of ME/CFS
3.7% were classified as having long COVID-19 without meeting ME/CFS criteria
Inferred Conclusions
A relationship exists between COVID-19 infection and ME/CFS development
The prevalence of post-COVID ME/CFS is similar to or slightly higher than background ME/CFS prevalence in the general population
Systematic follow-up of COVID-19 patients is necessary to identify and manage emerging ME/CFS cases
Family history of ME/CFS may be relevant to understanding susceptibility to post-COVID ME/CFS
Remaining Questions
What is the natural history of post-COVID ME/CFS—do symptoms persist, remit, or evolve over longer follow-up periods?
Which specific pathophysiological mechanisms explain the overlap between COVID-19 and ME/CFS (viral persistence, immune dysregulation, mitochondrial dysfunction, etc.)?
What This Study Does Not Prove
This cross-sectional study cannot establish causation—it shows correlation at a single time point but does not prove COVID-19 caused the ME/CFS. The study excluded people with BMI ≥40 kg/m², limiting generalizability. It cannot determine whether these cases represent new-onset ME/CFS or pre-existing undiagnosed cases unmasked by COVID-19.
Tags
Symptom:Post-Exertional MalaiseFatigue
Phenotype:Infection-TriggeredLong COVID Overlap
Method Flag:PEM Not DefinedNo ControlsMixed Cohort
Does the presence of family history of ME/CFS predict higher risk of developing ME/CFS after COVID-19, and what are the genetic or environmental factors involved?
How do the clinical and immunological profiles of post-COVID ME/CFS compare to traditional ME/CFS or to long COVID-19 without ME/CFS criteria?