Frontiers in Neurology (Feb 2023)

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

  • Hector Bonilla,
  • Tom C. Quach,
  • Anushri Tiwari,
  • Andres E. Bonilla,
  • Mitchell Miglis,
  • Phillip C. Yang,
  • Lauren E. Eggert,
  • Husham Sharifi,
  • Audra Horomanski,
  • Aruna Subramanian,
  • Liza Smirnoff,
  • Norah Simpson,
  • Houssan Halawi,
  • Oliver Sum-ping,
  • Agnieszka Kalinowski,
  • Zara M. Patel,
  • Robert William Shafer,
  • Linda N. Geng

DOI
https://doi.org/10.3389/fneur.2023.1090747
Journal volume & issue
Vol. 14

Abstract

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BackgroundThe 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.MethodsWe 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.FindingsThe 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.InterpretationsMost 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.

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