Fibromyalgia Symptoms More Common in Patients With Postacute COVID-19 Syndrome

While obesity and male gender are factors associated with developing post-COVID-19 fibromyalgia (FM), with approximately 30% of patients affected, clinical features of FM are more common in participants who had postacute COVID-19 syndrome (PACS), according to a study published in BMJ.¹

“Postacute COVID-19 syndrome (PACS) is an emerging entity characterized by a large array of manifestations, including musculoskeletal complaints, fatigue and cognitive or sleep disturbances,” investigators explained. “Since similar symptoms are present also in patients with FM, we decided to perform a web-based cross-sectional survey aimed at investigating the prevalence and predictors of FM in patients who recovered from COVID-19.”

Web-based cross-sectional data was collected in April 2021 using a 28-question survey. Information included demographics, marital status, occupational status, height and weight, details of COVID-19, and comorbidities. The American College of Rheumatology (ACR) Survey, as well as the Fibromyalgia Impact Questionnaire (FIQ), were used in the self-assessment. The first section of the survey acquired demographics, the second part of the survey determined FM status, and the third part focused on the FIQ. Individuals 18 years or older who developed COVID-19 before the survey publication were included.

A total of 616 participants responded to the survey after COVID-19 diagnosis, of which 77.4% were women with a mean age of 45 years and 30.7% (n = 189) satisfied the ACR survey criteria (56.6% female). Among respondents, COVID-19 duration was 13 days and 10.7% required hospital admission.

Common comorbidities were anxiety (17.5%), obesity (16.6%), and high blood pressure (15.7%). Male gender (OR: 9.95, 95% CI 6.02 to 16.43, p<0.0001) and obesity (OR: 41.20, 95% CI 18.00 to 98.88, p<0.0001) were the 2 factors most likely to predict PACS FM. Hospital admission was higher in men when compared with women (15.8% vs 9.2%, p=0.001) as well as obese (19.2 vs 10.8%, p=0.016) patients. The body mass index (BMI) and percentage of overweight patients were also higher in the male cohort.

Online surveys limit generalizability of the findings as participants were not selected through probability sampling, non-respondent information is not available, and selection bias may factor into responses. Additionally, younger males of lower socioeconomic status are less likely to complete similar surveys.

“From the rheumatology perspective, some open questions need to be addressed in the near future,” investigators concluded. “Easy-to-use, inexpensive and quick instruments, such as the Fibromyalgia Rapid Screening Tool questionnaire or the London Fibromyalgia Epidemiology Study Screening Questionnaire, may be the answer, but they need adequate validation in this new population of patients… Prospective studies, including comparative analysis with primary FM cohorts, will shed light on this topic.”

Reference:

Ursini F, Ciaffi J, Mancarella L, et al. Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey. RMD Open. 2021;7(3):e001735. doi:10.1136/rmdopen-2021-001735