tetano
Editor, Senior Moderator
JAMA Netw Open
. 2024 Jul 1;7(7):e2423555.
doi: 10.1001/jamanetworkopen.2024.23555. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After SARS-CoV-2 Infection
Elizabeth R Unger[SUP] 1 [/SUP], Jin-Mann S Lin[SUP] 1 [/SUP], Lauren E Wisk[SUP] 2 [/SUP], Huihui Yu[SUP] 3 [/SUP], Michelle L'Hommedieu[SUP] 2 [/SUP], Helen Lavretsky[SUP] 4 [/SUP], Juan Carlos C Montoy[SUP] 5 [/SUP], Michael A Gottlieb[SUP] 6 [/SUP], Kristin L Rising[SUP] 7 8 [/SUP], Nicole L Gentile[SUP] 9 10 11 [/SUP], Michelle Santangelo[SUP] 12 [/SUP], Arjun K Venkatesh[SUP] 3 13 [/SUP], Robert M Rodriguez[SUP] 5 [/SUP], Mandy J Hill[SUP] 14 [/SUP], Rachel E Geyer[SUP] 10 [/SUP], Efrat R Kean[SUP] 7 [/SUP], Sharon Saydah[SUP] 15 [/SUP], Samuel A McDonald[SUP] 16 17 [/SUP], Ryan Huebinger[SUP] 14 [/SUP], Ahamed H Idris[SUP] 16 [/SUP], Jocelyn Dorney[SUP] 3 [/SUP], Bala Hota[SUP] 18 [/SUP], Erica S Spatz[SUP] 3 19 [/SUP], Kari A Stephens[SUP] 10 20 [/SUP], Robert A Weinstein[SUP] 12 21 [/SUP], Joann G Elmore[SUP] 2 [/SUP]; Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group
Collaborators, Affiliations
Importance: Chronic 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).
Objective: To 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 participants: This 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.
Exposure: COVID-19 status (positive vs negative) at enrollment.
Main outcome and measures: The 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.
Results: A 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 relevance: In 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.
. 2024 Jul 1;7(7):e2423555.
doi: 10.1001/jamanetworkopen.2024.23555. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After SARS-CoV-2 Infection
Elizabeth R Unger[SUP] 1 [/SUP], Jin-Mann S Lin[SUP] 1 [/SUP], Lauren E Wisk[SUP] 2 [/SUP], Huihui Yu[SUP] 3 [/SUP], Michelle L'Hommedieu[SUP] 2 [/SUP], Helen Lavretsky[SUP] 4 [/SUP], Juan Carlos C Montoy[SUP] 5 [/SUP], Michael A Gottlieb[SUP] 6 [/SUP], Kristin L Rising[SUP] 7 8 [/SUP], Nicole L Gentile[SUP] 9 10 11 [/SUP], Michelle Santangelo[SUP] 12 [/SUP], Arjun K Venkatesh[SUP] 3 13 [/SUP], Robert M Rodriguez[SUP] 5 [/SUP], Mandy J Hill[SUP] 14 [/SUP], Rachel E Geyer[SUP] 10 [/SUP], Efrat R Kean[SUP] 7 [/SUP], Sharon Saydah[SUP] 15 [/SUP], Samuel A McDonald[SUP] 16 17 [/SUP], Ryan Huebinger[SUP] 14 [/SUP], Ahamed H Idris[SUP] 16 [/SUP], Jocelyn Dorney[SUP] 3 [/SUP], Bala Hota[SUP] 18 [/SUP], Erica S Spatz[SUP] 3 19 [/SUP], Kari A Stephens[SUP] 10 20 [/SUP], Robert A Weinstein[SUP] 12 21 [/SUP], Joann G Elmore[SUP] 2 [/SUP]; Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group
Collaborators, Affiliations
- PMID: 39046739
- PMCID: PMC11270135
- DOI: 10.1001/jamanetworkopen.2024.23555
Importance: Chronic 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).
Objective: To 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 participants: This 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.
Exposure: COVID-19 status (positive vs negative) at enrollment.
Main outcome and measures: The 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.
Results: A 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 relevance: In 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.