Elevated risk of new-onset chronic fatigue syndrome/myalgic encephalomyelitis up to four years after SARS-CoV-2 infection.

ingentiumby ingentium

In Long Covid Literature.

Publication date: Jul 23, 2025

Fatigue is a common sequela of SARS-CoV-2 infection, with many COVID-19 patients subsequently developing chronic fatigue syndrome and myalgic encephalomyelitis (CFS/ME). Long-term associations between COVID-19, new-onset CFS/ME, and other independent predictors such as vaccination for SARS-CoV-2, re-infection, and blood biomarkers at time of infection remain unclear. This study investigated the incidence and independent predictors of developing new-onset CFS/ME up to 4 years post SARS-CoV-2 infection in comparison to COVID- controls. This retrospective analysis conducted within the Montefiore Health System from February 1, 2020, to January 12, 2024 included adults without a prior diagnosis of fatigue or CFS/ME who were hospitalized for COVID-19 (n = 10,667), not hospitalized for COVID-19 (n = 25,409), and non-COVID-19 controls (n = 111,301). The observation time was between 30 days and 4 years post index date. The outcome was new-onset CFS/ME. Multivariate adjusted hazard ratios (HR) with 95% confidence intervals were calculated, assessing risk posed by SARS-CoV-2 infection, re-infection, and vaccination. Whether abnormal levels of aspartate aminotransferase, creatinine, D-dimer, lactate dehydrogenase, ferritin, hemoglobin, platelets, neutrophil/lymphocyte ratio, and temperature during hospitalization were associated with future CFS/ME risk was examined. Compared to COVID- controls, the risk of developing new-onset CFS/ME was higher among both COVID-19 hospitalized (adjusted HR = 1. 46 [1. 07, 1. 99]) and non-hospitalized patients (1. 56 [1. 25, 1. 93]). Females (1. 54 [1. 27, 1. 89]), patients with liver disease (1. 61 [1. 29, 2. 00]), autoimmune disorders (1. 57 [1. 18, 2. 08]), and anxiety disorders (1. 35 [1. 04, 1. 74]) were more likely to develop CFS/ME (p 

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Concepts Keywords
February Chronic fatigue syndrome
Females COVID-19
Hospitalization Epidemiology
Long-COVID
Myalgic encephalomyelitis
Post-acute sequelae
Risk factors

Semantics

Type Source Name
disease MESH chronic fatigue syndrome
disease MESH SARS-CoV-2 infection
pathway REACTOME SARS-CoV-2 Infection
disease MESH re-infection
disease IDO blood
disease MESH infection
drug DRUGBANK Creatinine
disease MESH liver disease
disease MESH anxiety disorders
disease MESH Long Covid
disease MESH encephalomyelitis
disease MESH psychiatric disorder
disease IDO history
disease MESH depressive disorder
disease MESH COPD
disease MESH Hypertension
disease MESH Type 2 diabetes
disease MESH Asthma
pathway KEGG Asthma
disease MESH panic
disease MESH respiratory infections
disease MESH cognitive dysfunction
disease MESH anxiety
disease MESH causality
drug DRUGBANK Coenzyme M
disease IDO susceptibility
disease MESH misdiagnosis
disease IDO acute infection
disease MESH relapse
disease MESH tic
disease MESH education level
disease MESH syndromes
disease MESH privacy
disease MESH inflammation
disease IDO cell
drug DRUGBANK Lysozyme
disease MESH Neuroinflammation
disease MESH morbidity
disease MESH influenza
disease MESH acute kidney injury
drug DRUGBANK (S)-Des-Me-Ampa
drug DRUGBANK Hexachlorophene
disease MESH diabetic ketoacidosis
disease MESH multiple sclerosis
disease MESH dementia
disease MESH essential tremor
disease MESH Parkinson’s disease
disease MESH abnormalities
drug DRUGBANK Trestolone
disease MESH depression
disease MESH Autoimmunity
disease MESH fibromyalgia
disease MESH chronic hepatitis
disease MESH hepatitis
disease MESH virus infection
disease MESH myelitis
disease MESH cardiovascular disease
drug DRUGBANK L-Leucine
disease MESH physical inactivity
disease MESH sequelae

Original Article

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