Post-Acute COVID-19 Symptoms, a Potential Link with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A 6-Month Survey in a Mexican Cohort

Abstract

The aim of this study was to describe the clinical evolution during 6 months of follow-up of adults recovered from COVID-19. We tried to determine how many met the definition of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). A total of 130 patients (51.0 ± 14 years, 34.6% female) were enrolled. Symptoms were common, participants reported a median number of 9 (IQR 5–14) symptoms. Fatigue was the most common symptom (61/130; 46.9%). Patients with fatigue were older 53.9 ± 13.5 years compared with 48.5 ± 13.3 years in those without fatigue (p = 0.02) and had a longer length of hospital stay, 17 ± 14 days vs. 13 ± 10 days (p = 0.04). There was no difference in other comorbidities between patients with fatigue and those without it, and no association between COVID-19 severity and fatigue. After multivariate adjustment of all baseline clinical features, only age 40 to 50 years old was positively associated with fatigue, OR 2.5 (95% CI 1.05–6.05) p = 0.03. In our survey, only 17 (13%) patients met the Institute of Medicine’s criteria for “systemic exertion intolerance disease,” the new name of ME/CFS. In conclusion, in some patients, the features of post-acute COVID-19 syndrome overlap with the clinical features of ME/CFS.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): An Overview

“…A retrospective analysis reported that 85.3% of 231 COVID-19 survivors gathered from the Genome Database of Latvian Population national biobank reached the threshold for ME/CFS diagnosis, with three or more long-term ME/CFS-like symptoms persisting at 6 months follow-up [ 185 ]. A single-center prospective longitudinal study found that only 13% of 130 patients with moderate-to-severe COVID-19 pneumonia met the criteria for ME/CFS 6 months after discharge [ 186 ]. In a small, single-center pilot study, ME/CFS-like features were found in 27% of 37 COVID-19 survivors, six months after recovery, with no difference in clinical inflammation, lung function, serum neurofilament light chain (a biomarker of axonal damage), and objective cognitive testing when comparing patients with versus without ME/CFS-like features [ 187 ].…”

Long COVID: rheumatologic/musculoskeletal symptoms in hospitalized COVID-19 survivors at 3 and 6 months

“…In the literature, some observational studies investigated the persistent symptoms in hospitalized COVID-19 survivors beyond 3 months [9][10][11][12][13]. Ghosn and colleagues analyzed 1137 hospitalized survivors (of which 288 admitted to the intensive care unit) and found that 60% had at least one symptom at 6 months, most frequently fatigue, dyspnea, joint pain, and muscle pain [11].…”

“…Garrigues and colleagues assessed 120 survivors through telephone surveys after a mean of 111 days after admission either to the hospital ward unit (n = 96) or to the intensive care unit (n = 24) and documented that 54.2% had fatigue, 39.6% had dyspnea, 14.6% had cough, 14.6% had anosmia, and 9.4% had ageusia in the hospital ward unit group [9]. González-Hermosillo and colleagues assessed 130 survivors through telephone surveys and reported that 46.9% had fatigue, 43.8% joint pain, 42.3% had dyspnea, 36.2% muscle pain, 6.9% had anosmia, and 5.4% had ageusia at 6 months [10]. Fortini and colleagues assessed 59 survivors after a median of 123 days after discharge from the hospital ward unit and observed that 42.4% had fatigue, 37.3% had dyspnea, 16.9% had ageusia, 15.2% had anosmia, 11.9% had cough, 8.5% joint pain, and 8.5% myalgia [13].…”

“…Several observational studies have recently evaluated the persistent symptoms in hospitalized COVID-19 survivors beyond 3 months [9][10][11][12][13]. Although some of these studies have partly described the persistent fatigue, myalgia, and joint pain in hospitalized COVID-19 survivors, they only reported their prevalence.…”

Long-COVID: Langzeitsymptome und morphologische/radiologische Korrelate

“…Schätzungsweise 836.000 bis 2,5 Mio. Amerikaner leiden an ME/CFS, und etwa 90 % der Menschen mit ME/CFS wurden nicht diagnostiziert (CDC) [ 11 ]. Die Pathologie von ME/CFS ist nicht bekannt: Eine multifaktorielle Genese und eine Fehlregulation mehrerer Kreisläufe als Reaktion auf einen bestimmten Auslöser wird diskutiert.…”