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.
Level 4 - case-series / case-control
Retrospective single-center case series of clinic patients without a control group.
PubMed 36908615 · doi:10.3389/fneur.2023.1090747
What was done
A retrospective chart review of 140 adult patients with post-acute sequelae of SARS-CoV-2 infection (PASC) evaluated at a specialized post-COVID-19 multidisciplinary clinic. Investigators evaluated patient demographics, risk factors, illness severity (graded 1 to 5), functional status, and 29 specific symptoms. The 2015 Institute of Medicine (IOM) criteria were applied to identify patients meeting the case definition for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
What was found
In the cohort of 140 patients (median age 47 years, 59.0% female, 12.7% hospitalized for acute infection, 53.5% with no prior comorbidities), median symptom duration was 285.5 days with a median of 12 symptoms. Overall, 33.9% experienced severe functional debilitation. The most prevalent symptoms were fatigue (86.5%), post-exertional malaise (82.8%), brain fog (81.2%), unrefreshing sleep (76.7%), and lethargy (74.6%). Forty-three percent met the IOM criteria for ME/CFS. The ME/CFS phenotype was significantly associated with obesity (BMI > 30 kg/m², P = 0.00377895) and worse functional status (P = 0.0110474).
Why it matters
This study shows that over 40% of patients attending a post-COVID clinic fit the clinical case definition for ME/CFS even after mild initial infections, underscoring significant symptom overlap and post-viral functional impairment.
Limits
Single-center retrospective design without a control group of recovered or uninfected individuals. Referral to a specialized post-COVID clinic introduces substantial selection bias toward patients with more persistent or severe symptoms.
Cited by
- context 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.