Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic. — CFSMEATLAS
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic.
Bonilla, Hector, Quach, Tom C, Tiwari, Anushri et al. · Frontiers in neurology · 2023 · DOI
Quick Summary
This study looked at 140 people suffering from long COVID symptoms and found that nearly half of them (43%) met the medical criteria for ME/CFS. Most patients had severe fatigue, brain fog, and unrefreshing sleep that lasted around 9-10 months on average. People with higher body weight and greater functional decline were more likely to develop the ME/CFS form of long COVID.
Why It Matters
This study provides critical epidemiological evidence that ME/CFS represents a substantial disease burden within the PASC population, with approximately 1 in 2.3 long COVID patients meeting formal diagnostic criteria. Understanding ME/CFS prevalence in post-COVID cohorts helps clinicians recognize this serious subtype and may guide patient stratification for future mechanistic and therapeutic research.
Observed Findings
43% of PASC patients (n=60/140) met IOM 2015 criteria for ME/CFS
Fatigue, post-exertional malaise, and cognitive dysfunction were the three most prevalent symptoms (≥81%)
Median symptom duration was 285.5 days with median 12 total symptoms reported
Obesity (BMI >30) and worse functional status were significantly associated with ME/CFS diagnosis
33.9% of the cohort (n=45) experienced significant functional debilitation
Inferred Conclusions
ME/CFS is a common phenotypic presentation in PASC, affecting approximately 43% of clinic-evaluated patients
Obesity and baseline functional decline may be risk factors or markers for developing ME/CFS within long COVID
Most PASC patients with ME/CFS were not hospitalized during acute COVID-19, suggesting ME/CFS can develop from mild-to-moderate acute infections
Multidisciplinary clinical assessment can effectively identify ME/CFS cases in PASC populations for targeted management
Remaining Questions
What biological mechanisms explain the association between obesity and ME/CFS development in PASC?
What This Study Does Not Prove
This study does not establish causation between COVID-19 infection and ME/CFS development, nor does it identify the biological mechanisms underlying either condition. The cross-sectional design cannot determine whether obesity and functional decline preceded or resulted from ME/CFS, and findings from a specialized clinic population may not generalize to all PASC patients.