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COVID-19 may trigger chronic fatigue syndrome

Kaiser Permanente researchers are following a group of patients to learn more about the debilitating condition and its connection to COVID-19.

A study following Kaiser Permanente Northern California patients with chronic fatigue-like symptoms in 2022 estimated that 14% of them developed symptoms after having COVID-19.

The study, published in the “PLOS ONE” journal, explored the relationship between COVID-19 and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a debilitating condition that can include extreme fatigue, post-exertional malaise, sleep issues, and brain fog or dizziness. ME/CFS is the current term for an illness known in the past as chronic fatigue syndrome.

All the patients with this condition had major impairment in physical, mental, emotional, social, and occupational functioning compared with patients without the illness.

“It’s hard to over-estimate the dramatic impact this illness has on their lives,” said senior author Jacek Skarbinski, MD, a research scientist with the Kaiser Permanente Division of Research and infectious diseases physician with The Permanente Medical Group.

The researchers were interested in learning whether COVID-19 may have caused some cases of this syndrome. Their results suggest it may have played a role, but more research is needed to get a complete picture.

“Our results offer a snapshot in time,” Dr. Skarbinski said. “We can’t yet say whether COVID added to the overall incidence of ME/CFS. We expect to know more in the next stages of our study.”

The researchers surveyed 9,825 patients about their symptoms and their COVID-19 history.

“We cast a wide net to find people who might have symptoms that fit the definition of ME/CFS but had not been diagnosed,” said lead author Mariah S. Wood, a data analyst with the Division of Research.

Overall, the researchers estimated that 1.7%, or 45,892, of 2.7 million adult Kaiser Permanente Northern California members had ME/CFS-like syndrome during the study period, July to October 2022. Of those, 14% developed the illness after COVID-19.

The patients with the syndrome began after COVID-19 were more likely to be unvaccinated against COVID-19 and to have had COVID-19 before June 2021.

Those whose symptoms began after COVID-19 were more likely to have better physical functioning but greater anxiety and less energy than those with this condition whose symptoms were not associated with COVID-19.

Other research has suggested there also could be overlap between patients with ME/CFS and those reporting long COVID, a condition involving COVID-19 symptoms that persist over a long period.

Dr. Skarbinski said this study could shed light on questions of COVID-19’s role and any relationship between ME/CFS and long COVID, as researchers continue to survey the patients over time.

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