Post-Acute COVID-19 Symptoms, a Potential Link with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A 6-Month Survey in a Mexican Cohort

Abstract

The aim of this study was to describe the clinical evolution during 6 months of follow-up of adults recovered from COVID-19. We tried to determine how many met the definition of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). A total of 130 patients (51.0 ± 14 years, 34.6% female) were enrolled. Symptoms were common, participants reported a median number of 9 (IQR 5-14) symptoms. Fatigue was the most common symptom (61/130; 46.9%). Patients with fatigue were older 53.9 ± 13.5 years compared with 48.5 ± 13.3 years in those without fatigue (p = 0.02) and had a longer length of hospital stay, 17 ± 14 days vs. 13 ± 10 days (p = 0.04). There was no difference in other comorbidities between patients with fatigue and those without it, and no association between COVID-19 severity and fatigue. After multivariate adjustment of all baseline clinical features, only age 40 to 50 years old was positively associated with fatigue, OR 2.5 (95% CI 1.05-6.05) p = 0.03. In our survey, only 17 (13%) patients met the Institute of Medicine's criteria for "systemic exertion intolerance disease," the new name of ME/CFS. In conclusion, in some patients, the features of post-acute COVID-19 syndrome overlap with the clinical features of ME/CFS.

Keywords: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome; fatigue; symptoms of COVID-19.

Figure 1

Flow Chart of the Study Design. * Comorbidities: Hypertension, Diabetes, Chronic obstructive pulmonary disease, Chronic Heart disease, Chronic Kidney disease, Immunosuppressive condition or Psychiatric disorder.

Figure 2

Associated factors in Chronic Fatigue in Post COVID-19. The 95% confidence intervals (CI) of the odds ratios have been adjusted for multiple testing. In bold, independent predictors associated with the outcomes. To the purpose of logistic regression, variables were categorized regarding their 75-percentiles or lowest levels where 25-percentiles were used of our population. C-Reactive Protein (CRP), High sensitive cardiac Troponin I (hs-cTnI), Interleukin-6 (IL-6), Vascular Endothelial Growth Factor (VEGF).