Shadow Burden of Undiagnosed Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) on Society: Retrospective and Prospective-In Light of COVID-19.
Level 4 - case-series / case-control
Cross-sectional survey comparison and economic modeling
PubMed 34300183 · doi:10.3390/jcm10143017
What was done
The authors combined literature review, economic estimation, and empirical survey analyses to evaluate the societal and economic burden of undiagnosed ME/CFS in Latvia, as well as the prospective impact of COVID-19. The empirical study had two components: (1) a comparison of self-reported symptoms and characteristics between diagnosed ME/CFS patients and undiagnosed individuals experiencing similar symptoms; and (2) a survey of former COVID-19 patients evaluating ME/CFS-like symptoms 6 months post-infection. Descriptive and analytical statistical methods were applied to evaluate symptom profiles and project direct medical out-of-pocket costs.
What was found
The literature and local data estimated an ME/CFS prevalence of 0.8% in Latvia (consistent with a literature range of 0.2–1.0% in developed countries), with the undiagnosed population estimated to be at least five times larger than the diagnosed cohort. Diagnosed and undiagnosed longstanding symptomatic patients reported similar symptom severity, whereas 6-month post-COVID-19 patients reported lower overall severity but significantly higher rates of psychological distress (anxiety) and episodic fatigue. Direct out-of-pocket medical costs for undiagnosed patients in Latvia were calculated at over €15 million annually, projected to increase by at least 15% following COVID-19 post-viral sequelae.
Why it matters
Underdiagnosis of ME/CFS creates substantial hidden economic and healthcare burdens, which post-viral syndromes stemming from COVID-19 are likely to amplify.
Limits
Participant sample sizes for the survey cohorts were not reported in the abstract. Findings rely on self-reported survey data, hypothetical economic projections, and regional data specific to Latvia, limiting generalizability.
Cited by
- supports An estimated 3 to 5 million people in the US, 2 to 3 million in the UK, and 20 to 24 million worldwide have either ME/CFS or long COVID.