Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is common in post-acute sequelae of SARS-CoV-2 infection (PASC), 2022, Bonilla+

[SNT Gatchaman]

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic
Hector Bonilla, Tom Quach, Anushri Tiwari, Andres Bonilla, Mitchell G Miglis, PhillipYang, Lauren Eggert, Husham Sharifi, Audra Horomanski, Aruna K Subramanian, Liza Smirnoff, Norah Simpson, Houssam Halawi, Oliver Sum-Ping, Agnieszka Kalinowski, Zara Patel, Robert William Shafer, Linda Geng

Background
The global prevalence of PASC is estimated to be present in 0.43 and based on the WHO estimation of 470 million worldwide COVID-19 infections, corresponds to around 200 million people experiencing long COVID symptoms. Despite this, its clinical features are not well defined.

Methods
We collected retrospective data from 140 patients with PASC in a post-COVID-19 clinic on demographics, risk factors, illness severity (graded as one-mild to five-severe), functional status, and 29 symptoms and principal component symptoms cluster analysis. The Institute of Medicine (IOM) 2015 criteria were used to determine the ME/CFS phenotype.

Findings
The median age was 47 years, 59.0% were female; 49.3% White, 17.2% Hispanic, 14.9% Asian, and 6.7% Black. Only 12.7% required hospitalization. Seventy-two (53.5%) patients had no known comorbid conditions. Forty-five (33.9%) were significantly debilitated. The median duration of symptoms was 285.5 days, and the number of symptoms was 12. The most common symptoms were fatigue (86.5%), post-exertional malaise (82.8%), brain fog (81.2%), unrefreshing sleep (76.7%), and lethargy (74.6%). Forty-three percent fit the criteria for ME/CFS.

Interpretations
Most PASC patients evaluated at our clinic had no comorbid condition and were not hospitalized for acute COVID-19. One-third of patients experienced a severe decline in their functional status. About 43% had the ME/CFS subtype.

Medrxiv Preprint

 

[SNT Gatchaman]

Not large numbers, but some data to support the conjecture that probably most LC would fit criteria for ME. Arguably could have gone in the ME research section! I expect that by the time it's peer-reviewed and accepted there'll be other similar papers that can go there if desired.

Will be interesting to see how long-lived the term "long covid" is in the future. Suspect it will last, but probably more due to politics/advocacy than due to inclusion of eg late thromboembolic events that are orthogonal to the ME phenotype.

 

[RedFox]

I'm very glad to see a paper like this. Many people have said people are getting ME/CFS after Covid, but we finally have some numbers. 43% of long haulers ill enough to go to a specialist clinic. Next we need to research what percentage of all Covid-19 cases result in ME.

 

[SNT Gatchaman]

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic
Bonilla H, Quach TC, Tiwari A, Bonilla AE, Miglis M, Yang PC, Eggert LE, Sharifi H, Horomanski A, Subramanian A, Smirnoff L, Simpson N, Halawi H, Sum-Ping O, Kalinowski A, Patel ZM, Shafer RW, Geng LC

Background: The global prevalence of PASC is estimated to be present in 0·43 and based on the WHO estimation of 470 million worldwide COVID-19 infections, corresponds to around 200 million people experiencing long COVID symptoms. Despite this, its clinical features are not well-defined.

Methods: We collected retrospective data from 140 patients with PASC in a post-COVID-19 clinic on demographics, risk factors, illness severity (graded as one-mild to five-severe), functional status, and 29 symptoms and principal component symptoms cluster analysis. The Institute of Medicine (IOM) 2015 criteria were used to determine the Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) phenotype.

Findings: The median age was 47 years, 59.0% were female; 49.3% White, 17.2% Hispanic, 14.9% Asian, and 6.7% Black. Only 12.7% required hospitalization. Seventy-two (53.5%) patients had no known comorbid conditions. Forty-five (33.9%) were significantly debilitated. The median duration of symptoms was 285.5 days, and the number of symptoms was 12. The most common symptoms were fatigue (86.5%), post-exertional malaise (82.8%), brain fog (81.2%), unrefreshing sleep (76.7%), and lethargy (74.6%). Forty-three percent fit the criteria for ME/CFS, majority were female, and obesity (BMI > 30 Kg/m2) (P = 0.00377895) and worse functional status (P = 0.0110474) were significantly associated with ME/CFS.

Interpretations: Most PASC patients evaluated at our clinic had no comorbid condition and were not hospitalized for acute COVID-19. One-third of patients experienced a severe decline in their functional status. About 43% had the ME/CFS subtype.

PubMed | Link | PDF (Frontiers in Neurology)