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.


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.

Competing Interest Statement

Hector Bonilla, MD. Consultant for United Health. Tom C Quach, BS. No conflicts. Anushri Tiwari, BS. No conflicts. Andres Bonilla, BS. No conflicts. Mitchel Miglis, MD. Dysautonomia International Embr, Inc; Elsevier Royalties; 2nd MD, Infinite MD, Guidepoint LLC ; Med-IQ ; Van Cott and Talamante, LLC; Phillip Yang, MD. No conflicts. Lauren Eggert, MD. No conflicts. Husham Sharifi, MD. No conflicts. Audra Horomanski, MD. No conflicts. Aruna Subramanian, MD. No conflicts. Liza Smirnoff, MD. No conflicts. Norah Simpson, PhD. No conflicts. Houssam Halawi, MD. No conflicts. Oliver Sum-Ping, MD. No conflicts. Agnieszka Kalinowski, MD, PhD. Consultant for Pasethia. Zara M. Patel, MD. Elsevier, Springer, Wolters Kluwer, Medtronic, InfiniteMD, Regeneron/Sanofi, Johnson&Johnson, Scientific Advisory Board for Optinose and Dianosic, Patent filed on my behalf by Stanford OTL: S15-465 63/076,656 (S31-06935.PRO) Equity in Olfera Therapeutics, Robert Shafer, MD. Gilead Sciences GlaxoSmithKline, Linda Geng, MD PhD. Consultant for United Health Care

Funding Statement

This study did not receive any funding.

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The study was approved by the Stanford University Institutional Review Board

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Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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