Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After SARS-CoV-2 Infection
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Published:2024-07-24
Issue:7
Volume:7
Page:e2423555
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ISSN:2574-3805
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Container-title:JAMA Network Open
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language:en
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Short-container-title:JAMA Netw Open
Author:
Unger Elizabeth R.1, Lin Jin-Mann S.1, Wisk Lauren E.2, Yu Huihui3, L’Hommedieu Michelle2, Lavretsky Helen4, Montoy Juan Carlos C.5, Gottlieb Michael A.6, Rising Kristin L.78, Gentile Nicole L.91011, Santangelo Michelle12, Venkatesh Arjun K.313, Rodriguez Robert M.5, Hill Mandy J.14, Geyer Rachel E.10, Kean Efrat R.7, Saydah Sharon15, McDonald Samuel A.1617, Huebinger Ryan14, Idris Ahamed H.16, Dorney Jocelyn3, Hota Bala18, Spatz Erica S.319, Stephens Kari A.1020, Weinstein Robert A.1221, Elmore Joann G.2, Koo Katherine22, Derden Antonia22, Gatling Kristyn22, Guzman Diego22, Yang Geoffrey22, Kaadan Amro (Marshall)22, Hassaballa Minna22, Jerger Ryan22, Ahmed Zohaib22, Choi Michael22, Pavlopoulos Ariana22, Kesari Avinash22, Gaylord Caitlin A22, Gomez Chloe22, Lomas Elizabeth22, Boliboun Phouthavang (Jimmie)22, Patel Krisna22, Malicki Caitlin22, Lin Zhenqiu22, Li Shu-Xia22, Ebna Mannan Imtiaz22, Yang Zimo22, Liu Mengni22, Ulrich Andrew22, Kinsman Jeremiah22, Pierce Senyte22, Puente Xavier22, Salah Wafa22, Nichol Graham22, Anderson Jill22, Schiffgens Mary22, Morse Dana22, Adams Karen22, Stober Tracy22, Maat Zenoura22, O’Laughlin Kelli N.22, Willis Michael22, Zhang Zihan22, Chang Gary22, Lyon Victoria22, Klabbers Robin E.22, Ruiz Luis22, Malone Kerry22, Park Jasmine22, Renzi Nicole22, Watts Phillip22, Kelly Morgan22, Schaeffer Kevin22, Grau Dylan22, Cheng David22, Shutty Carly22, Charlton Alex22, Shughart Lindsey22, Shughart Hailey22, Amadio Grace22, Miao Jessica22, Hannikainen Paavali22, Chandler Chris22, Diaz Roldan Kate22, Eguchi Megan22, Moreno Raul22, Wang Ralph C.22, Kemball Robin22, Chan Virginia22, Lara Chavez Cecilia22, Wong Angela22, Arreguin Mireya22, Kane Arun22, Nikonowicz Peter22, Sapp Sarah22, Gallegos David22, Martin Katherine R.22, Plumb Ian D.22, Hall Aron J.22, Briggs-Hagen Melissa22,
Affiliation:
1. Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 2. Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles 3. Center for Outcomes Research & Evaluation (CORE), Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut 4. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California, Los Angeles 5. Department of Emergency Medicine, University of California, San Francisco 6. Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois 7. Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania 8. Jefferson Center for Connected Care, Sidney Kimmel Medical School, Thomas Jefferson University, Philadelphia, Pennsylvania 9. Post-COVID Rehabilitation and Recovery Clinic, University of Washington, Seattle 10. Department of Family Medicine, University of Washington, Seattle 11. Department of Laboratory Medicine and Pathology, University of Washington, Seattle 12. Division of Infectious Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois 13. Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut 14. Department of Emergency Medicine, UTHealth Houston, Houston, Texas 15. National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 16. Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas 17. Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas 18. Tendo Systems, Inc, Philadelphia, Pennsylvania 19. Department of Epidemiology, Yale School of Public Health, New Haven, Connecticut 20. Department of Biomedical Informatics and Medical Education, University of Washington, Seattle 21. Division of Infectious Diseases, Department of Medicine, Cook County Hospital, Chicago, Illinois 22. for the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group
Abstract
ImportanceChronic symptoms reported following an infection with SARS-CoV-2, such as cognitive problems, overlap with symptoms included in the definition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).ObjectiveTo evaluate the prevalence of ME/CFS-like illness subsequent to acute SARS-CoV-2 infection, changes in ME/CFS symptoms through 12 months of follow-up, and the association of ME/CFS symptoms with SARS-CoV-2 test results at the acute infection–like index illness.Design, Setting, and ParticipantsThis prospective, multisite, longitudinal cohort study (Innovative Support for Patients with SARS-CoV-2 Infections Registry [INSPIRE]) enrolled participants from December 11, 2020, to August 29, 2022. Participants were adults aged 18 to 64 years with acute symptoms suggestive of SARS-CoV-2 infection who received a US Food and Drug Administration–approved SARS-CoV-2 test at the time of illness and did not die or withdraw from the study by 3 months. Follow-up surveys were collected through February 28, 2023.ExposureCOVID-19 status (positive vs negative) at enrollment.Main Outcome and MeasuresThe main outcome was the weighted proportion of participants with ME/CFS-like illness based on the 2015 Institute of Medicine clinical case definition using self-reported symptoms.ResultsA total of 4378 participants were included in the study. Most were female (3226 [68.1%]). Mean (SD) age was 37.8 (11.8) years. The survey completion rates ranged from 38.7% (3613 of 4738 participants) to 76.3% (1835 of 4738) and decreased over time. The weighted proportion of participants identified with ME/CFS-like illness did not change significantly at 3 through 12 months of follow-up and was similar in the COVID-19–positive (range, 2.8%-3.7%) and COVID-19–negative (range, 3.1%-4.5%) groups. Adjusted analyses revealed no significant difference in the odds of ME/CFS-like illness at any time point between COVID-19–positive and COVID-19–negative individuals (marginal odds ratio range, 0.84 [95% CI, 0.42-1.67] to 1.18 [95% CI, 0.55-2.51]).Conclusions and RelevanceIn this prospective cohort study, there was no evidence that the proportion of participants with ME/CFS-like illness differed between those infected with SARS-CoV-2 vs those without SARS-CoV-2 infection up to 12 months after infection. A 3% to 4% prevalence of ME/CFS-like illness after an acute infection–like index illness would impose a high societal burden given the millions of persons infected with SARS-CoV-2.
Publisher
American Medical Association (AMA)
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