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People with fibromyalgia are all too familiar with its often-debilitating symptoms, which include widespread muscle and joint pain, fatigue, insomnia, and brain fog. Now a new study confirms that similar symptoms often arise in people with post-COVID syndrome.

Post-COVID syndrome — also known as long COVID, long-haul COVID, and post-acute sequelae of SARS-CoV-2 (PASC) — refers to health problems that persist in a subset of people who have technically recovered from COVID-19 (meaning they no longer have an active infection). This condition isn’t a single, specific health problem but rather a mix of symptoms that can vary widely from person to person. Long COVID might include organ damage, depression, persistent loss of taste and smell, or any other new health issue that crops up in the wake of COVID-19.

Post-COVID syndrome might also include neurological problems like fatigue, headaches, dizziness, and brain fog. This constellation of symptoms, of course, sounds a lot like fibromyalgia. To find out whether post-COVID syndrome was actually causing some people to develop fibromyalgia (including the chronic pain that goes along with it), Italian researchers decided to perform a web-based study.

The study, which was published in the journal RMD Open: Rheumatic & Musculoskeletal Diseases, surveyed more than 600 people who had recovered from COVID at least three months before the study began but had ongoing health problems. Those with a pre-existing fibromyalgia diagnosis or a history of chronic musculoskeletal pain were excluded.

Study participants completed surveys that asked about the severity of their COVID infection as well as symptoms that might pertain to fibromyalgia. The questions about fibromyalgia were based on the American College of Rheumatology’s Survey Criteria for Fibromyalgia, as well as the organization’s Fibromyalgia Impact Questionnaire.

The researchers found that about 30 percent of respondents with post-COVID syndrome seemed to meet the diagnostic criteria for fibromyalgia. They suggested that lingering inflammation and/or virus-induced damage to the endothelium (lining of the blood vessels) or immune system might be to blame.

“Some of the proinflammatory cytokines involved in COVID-19 and PACS manifestations, such as interleukin (IL)-1 and IL-6, may contribute to the pathogenesis of [fibromyalgia],” researchers wrote.

Surprisingly, this study found that men were more likely than women to develop symptoms consistent with fibromyalgia. (According to the U.S. Centers for Disease Control and Prevention, women are twice likely to have fibromyalgia as men.) Obesity was also identified as a strong risk factor for developing fibromyalgia-like symptoms after COVID-19 infection.

The researchers noted that “both male gender and obesity have been consistently associated with a more severe clinical course in patients with COVID-19” and speculated that having a more severe case of COVID might somehow predispose obese men to fibromyalgia. However, they did not find a significant increased risk of fibromyalgia among those who had been hospitalized with COVID.

“In the light of the overwhelming numbers of the SARS-CoV-2 pandemic, it is reasonable to forecast that rheumatologists will face up with a sharp rise of cases of a new entity that we defined ‘FibroCOVID,’” the authors concluded.

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COVID ‘Long Haulers’: Long-Term Effects of COVID-19. Johns Hopkins Medicine. April 1, 2021. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-long-haulers-long-term-effects-of-covid19.

Fibromyalgia. U.S. Centers for Disease Control and Prevention. January 6, 2020. https://www.cdc.gov/arthritis/basics/fibromyalgia.htm.

Ursini F, et al. Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey. RMD Open: Rheumatic & Musculoskeletal Diseases. 2021. doi: http://doi.org/10.1136/rmdopen-2021-001735.

Walsh N. Fibromyalgia: A New Feature of Long COVID? MedPage. August 31, 2021. https://www.medpagetoday.com/rheumatology/fibromyalgia/94299.

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