Fibromyalgia- A New Facet of Post COVID-19 Syndrome Spectrum

A web-based cross-sectional survey was conducted to understand the prevalence of fibromyalgia after an episode of symptomatic COVID-19 infection. From the data obtained from 616 patients, it was observed that fibromyalgia is common in COVID-19 recovered patients. 30.7% patients reported the presence of fibromyalgia. Although it is known that fibromyalgia is a female predominant disorder, the study showed a higher prevalence of fibromyalgia among the males. 43% of the males reported clinical features of fibromyalgia.

Furthermore, it was observed that fibromyalgia was associated with high body mass index. Obesity is a major predictor of fibromyalgia in post-COVID-19 patients. Patients with symptoms of fibromyalgia significantly reported higher proportions of cough, dyspnoea and requirement of supplemental oxygen during acute COVID-19. Furthermore, among self reported pre-existent comorbidities, high blood pressure was significantly more common in individuals with fibromyalgia. The occurrence of fibromyalgia was more significant in patients requiring hospital admission during acute COVID-19.

The proinflammatory cytokines involved in COVID-19 and PACS manifestations, such as interleukin (IL)-1 and IL-6 may contribute to the pathogenesis of fibromyalgia. Further investigation is required to understand the immunological association of COVID-19 and fibromyalgia. Although no definitive protocols are still available for post COVID-19 fibromyalgia treatment. But graded exercise, cognitive behavioural therapy and pain modulators will be helpful for patients.

Thus, from the study it can be concluded that fibromyalgia is a prominent feature of the post acute COVID-19 syndrome spectrum. Obesity and male gender synergistically affect the severity of COVID-19 that, in turn, may lead to post-COVID-19 fibromyalgia syndrome.

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