A comparison of pain, fatigue, and function between post-COVID-19 condition, fibromyalgia, and chronic fatigue syndrome: a survey study.
Haider, Saman, Janowski, Adam J, Lesnak, Joseph B et al. · Pain · 2023 · DOI
Quick Summary
This study surveyed 707 people with post-COVID-19, fibromyalgia, and/or ME/CFS to compare their symptoms. Researchers found that all three conditions share similar patterns of pain, fatigue, brain fog, anxiety, and depression that impact daily life. People with post-COVID-19 reported somewhat less severe pain and fatigue than those with fibromyalgia or ME/CFS, but those with multiple diagnoses had worse symptoms overall.
Why It Matters
This study helps establish that post-COVID-19 shares a clinical phenotype with ME/CFS and fibromyalgia, which may validate the experiences of post-COVID-19 patients and inform treatment approaches. Understanding symptom similarities across these conditions could accelerate research into shared biological mechanisms and facilitate development of targeted therapies. It highlights that a biopsychosocial management approach may benefit multiple post-viral/chronic conditions.
Observed Findings
All three conditions (post-COVID-19, FMS, and CFS) showed elevated pain, fatigue, anxiety, depression, catastrophizing, and kinesiophobia.
Physical and cognitive function were similarly impaired across all three diagnoses.
Post-COVID-19 participants reported significantly lower pain and fatigue severity compared to FMS and CFS groups.
Comorbid diagnoses (post-COVID-19 + FMS and/or post-COVID-19 + CFS) showed exacerbated pain, fatigue, and psychological symptoms compared to post-COVID-19 alone.
Dyspnea and sleep quality were assessed but detailed comparative findings were not emphasized in the abstract.
Inferred Conclusions
Post-COVID-19 presents a clinical symptom phenotype similar to fibromyalgia and ME/CFS, supporting a shared disease mechanism hypothesis.
Psychological factors (anxiety, depression, catastrophizing, kinesiophobia) are prominent across all three conditions and contribute to functional impairment.
A biopsychosocial management approach may be beneficial for post-COVID-19, similar to established approaches for FMS and ME/CFS.
The presence of comorbid diagnoses significantly worsens outcomes, suggesting these conditions may share underlying vulnerabilities.
Remaining Questions
What This Study Does Not Prove
This study does not establish whether post-COVID-19, fibromyalgia, and ME/CFS share the same underlying biological cause—only that symptoms overlap. The cross-sectional design cannot determine whether symptoms worsen or improve over time, or whether the psychological symptoms (anxiety, depression) are causes or consequences of the physical illness. It also does not prove that current fibromyalgia or ME/CFS treatments would be effective for post-COVID-19.