Prior COVID-19 infection and fibromyalgia criteria fulfillment: a comparative cross-sectional study

Fibromyalgia (FM) is a chronic widespread pain syndrome frequently accompanied by fatigue, cognitive dysfunction, psychological symptoms, and multiple somatic symptoms. Coronavirus disease 2019 (COVID-19) has affected millions worldwide; however, its long-term sequelae remain incompletely understood.

This study aimed to investigate whether prior COVID-19 infection was associated with a higher prevalence of fibromyalgia and to identify demographic and clinical factors associated with fibromyalgia in the study population.

This comparative cross-sectional study included 250 individuals with PCR-confirmed COVID-19 at least 3 months before assessment and 250 participants without a known history of confirmed COVID-19 infection. Data were collected at a single time point using a structured questionnaire and interview. Fibromyalgia status was defined as fulfillment of the modified 2016 American College of Rheumatology criteria.

Fibromyalgia criteria were fulfilled by 60/250 participants (24.0%) with prior COVID-19 infection compared with 35/250 participants (14.0%) in the comparison group. In crude analysis, prior COVID-19 infection was associated with higher odds of fibromyalgia criteria fulfillment (OR = 1.94, 95% CI: 1.22-3.07, p = 0.004). After adjustment for age group, sex, educational level, occupation, smoking status, and chronic disease, prior COVID-19 infection remained significantly associated with higher odds of fibromyalgia criteria fulfillment (adjusted OR = 2.18, 95% CI: 1.33-3.58, p = 0.002).

Prior COVID-19 infection remained associated with higher odds of modified 2016 ACR fibromyalgia criteria fulfillment. Female sex and non-employment were also associated with fibromyalgia criteria fulfillment, highlighting the need for clinical awareness and early recognition of fibromyalgia-like symptoms among individuals with a history of COVID-19 infection.