Prevalence and correlates of chronic fatigue syndrome and post-traumatic stress disorder after the outbreak of the COVID-19, Simani et al, 2021

[Andy]

As the SARS-COV-2 becomes a global pandemic, many researchers have a concern about the long COVID-19 complications. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a persistent, debilitating, and unexplained fatigue disorder. We investigated psychological morbidities such as CFS and post-traumatic stress disorder (PTSD) among survivors of COVID-19 over 6 months. All COVID-19 survivors from the university-affiliated hospital of Tehran, Iran, were assessed 6 months after infection onset by a previously validated questionnaire based on the Fukuda guidelines for CFS/EM and DSM-5 Checklist for PTSD (The Post-traumatic Stress Disorder Checklist for DSM-5 or PCL-5) to determine the presence of stress disorder and chronic fatigue problems. A total of 120 patients were enrolled.

The prevalence rate of fatigue symptoms was 17.5%. Twelve (10%) screened positive for chronic idiopathic fatigue (CIF), 6 (5%) for CFS-like with insufficient fatigue syndrome (CFSWIFS), and 3 (2.5%) for CFS. The mean total scores in PCL-5 were 9.27 ± 10.76 (range:0–44), and the prevalence rate of PTSD was 5.8%. There was no significant association after adjusting between CFS and PTSD, gender, comorbidities, and chloroquine phosphate administration. The obtained data revealed the prevalence of CFS among patients with COVID-19, which is almost similar to CFS prevalence in the general population. Moreover, PTSD in patients with COVID-19 is not associated with the increased risk of CFS. Our study suggested that medical institutions should pay attention to the psychological consequences of the COVID-19 outbreak.

Open access, https://link.springer.com/article/10.1007/s13365-021-00949-1

 

[Peter T]

A very small sample to draw population wide conclusions, also is there any guarantee that people catching Covid-19 and being admitted to this one hospital are representative of a normal population.

I am also puzzled that they don’t mention in the abstract the unambiguously physical sequelae of Covid-19 relating to heart, lung and neurological issues.

 

[ME/CFS Skeptic]

This looks like the first study that tested for ME/CFS six months after COVID-19.

Unfortunately, they didn't do a proper medical examination as most case definitions of ME/CFS require. They simply used a questionnaire where patients could indicate the severity of each of the Fukuda-criteria symptoms.

Baraniuk has previously used that approach and found that approximately 2% of patients met the Fukuda criteria (most likely a severe overestimate considering not all requirements of the diagnostic criteria were met).

In this Iranian study on COVID-19, 2.5% met the ME/CFS definition Baraniuk used previously. The authors write about this:

Our study demonstrated that the measured CFS prevalence following COVID-19 is 2.5% (3 out of 120); on the other hand, the estimated prevalence of chronic fatigue syndrome in a general population using the Fukuda criteria is around 2% (Baraniuk 2017). Therefore, there is well within this ballpark of population prevalence. This finding would suggest that the contribution of COVID-19 disease to the future risk of CFS is minimal.

 

[Andy]

Our study demonstrated that the measured CFS prevalence following COVID-19 is 2.5% (3 out of 120); on the other hand, the estimated prevalence of chronic fatigue syndrome in a general population using the Fukuda criteria is around 2% (Baraniuk 2017). Therefore, there is well within this ballpark of population prevalence. This finding would suggest that the contribution of COVID-19 disease to the future risk of CFS is minimal.

Um, OK, it doesn't increase the risk (as per their results) but given that Iran has reported 1.45m infections, an additional 29k ME patients is not an insignificant problem to deal with (assuming 2% prevelance).

 

[ME/CFS Skeptic]

Um, OK, it doesn't increase the risk (as per their results) but given that Iran has reported 1.45m infections, an additional 29k ME patients is not an insignificant problem to deal with (assuming 2% prevelance).

There are multiple differences between the populations studied by Baraniuk and the Iranian study so their prevalences might not be directly comparable unless there are some huge differences (e.g. 5-10 times higher in the post-COVID-19 population). That wasn't the case here and I suspect that's what the authors mean: the 0.5% difference falls within the uncertainty of their comparison.