“Long COVID-19” and viral “fibromyalgia-ness”: Suggesting a mechanistic role for fascial myofibroblasts (Nineveh, the shadow is in the fascia) 2023

• Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus

The coronavirus pandemic has led to a wave of chronic disease cases; “Long COVID-19” is recognized as a new medical entity and resembles “fibromyalgia” which, likewise, lacks a clear mechanism. Observational studies indicate that up to 30%–40% of convalescent COVID-19 patients develop chronic widespread pain and fatigue and fulfill the 2016 diagnostic criteria for “fibromyalgia.”

A recent study suggested a theoretical neuro-biomechanical model (coined “Fascial Armoring”) to help explain the pathogenesis and cellular pathway of fibromyalgia, pointing toward mechanical abnormalities in connective tissue and fascia, driven by contractile myo/fibroblasts and altered extracellular matrix remodeling with downstream corresponding neurophysiological aberrations.

This may help explain several of fibromyalgia’s manifestations such as pain, distribution of pain, trigger points/tender spots, hyperalgesia, chronic fatigue, cardiovascular abnormalities, metabolic abnormalities, autonomic abnormalities, small fiber neuropathy, various psychosomatic symptoms, lack of obvious inflammation, and silent imaging investigations. Pro-inflammatory and pro-fibrotic pathways provide input into this mechanism via stimulation of proto/myofibroblasts.

In this hypothesis and theory paper the theoretical model of Fascial Armoring is presented to help explain the pathogenesis and manifestations of “long COVID-19” as a disease of immuno-rheumo-psycho-neurology. The model is also used to make testable experimental predictions on investigations and predict risk and relieving factors.

eta: forgot the link (oops)
https://www.frontiersin.org/articles/10.3389/fmed.2023.952278/full

 

Link here:
https://www.frontiersin.org/articles/10.3389/fmed.2023.952278/full

Based on the abstract, this does not sound like a serious paper to be honest.

 

Author: Shiloh Plaut, and his bio in the journal lists one other publication (acupuncture hypothesis FM).

His field is "rheumapsychoneurology (fascial armoring), psychosomatics, fibromyalgia and myofascial pain."

For some reason, I don't feel the myofascial aspect is hugely important in pain generation and maintenance in FM. More like an invisible dish of condiment.

But sure, hypothesis-generate away and link those sausages while you're at it (re: Long Covid).