ABSTRACT
Purpose: To estimate the prevalence of fibromyalgia (FM), 'fibromyalgianess' and fatigue six months following COVID-19 infection. Method: Consecutive consenting patients were recruited from a post-COVID-19 infection clinic. The following self-reported questionnaires were completed 6 months following COVID-19 infection: widespread pain index (WPI), symptom severity scale (SSS), 10-point visual analogue scale to assess fatigue severity (VAS-F) and 9-item, 7-point fatigue severity scale (FSS). The sum of SSS and WPI scores was used to calculate a polysymptomatic distress (PSD) score. FM was defined as per the 2016 revisions to the 2010/2011 American College of Rheumatology (ACR) criteria, and 'fibromyalgianess' was defined using polysymptomatic distress scale recognising the continuum of FM symptoms. Results: Of 25 study participants, the median age was 59 years (range 21-80), nine were female (36%) and 15 had been admitted to hospital for Covid-related complications (60%). Six months following infection, five met WPI and SSS criteria for fibromyalgia and three others had PSD scores >12 suggestive of severe symptoms;all were under 60 years. Problematic fatigue (mean FSS > 4) occurred in nine patients (36%) and although not statistically significant it was seen more frequently in females compared with males (56% vs 25%;95% CI -9% to 71%) and in those <60 years (46% vs 25%;CI -16% to 58%). Mean (± SD) FSS was 29.7 (± 15.0) and VAS-F was 6.0 (± 2.9). Compared to male patients, female patients demonstrated statistically significant higher mean WPI (8.0 vs 2.0), SSS (7.0 vs 2.1) and PSD (15.0 vs 4.1). Conclusion: Six months following COVID-19 infection, fibromyalgia, 'fibromyalgianess' and fatigue are common, with higher frequency in females and younger patients. This pattern parallels conventional fibromyalgia cohorts and may favour targeted service delivery. Further studies are needed to determine whether symptoms persist long-term.
ABSTRACT
Purpose: To correlate internet search activity for fibromyalgia (FM) and its symptoms in relation to case numbers during the COVID-19 pandemic. Methods: Search terms chosen for inclusion included 'fibromyalgia', 'pain', 'joint pain', 'muscle ache', 'extreme fatigue' and 'poor sleep', based on a review of the most common symptoms reported among patients with FM. Positive control terms of 'fever' and 'cough' were used and 'rash' was a negative control. Google Trends was used to determine the frequency of search terms as a relative search volume (RSV) and queries for selected search terms were set with filters for specific dates and location. COVID-19 case numbers in Australia were obtained from the Australian Department of Health. Results: The average 2020 FM search volume in Australia was slightly less than the previous three years (RSV 47 vs RSV 49-53). While an increase in COVID-19 cases in Australia in August and September correlated with increased search popularity, similar increases were demonstrated in 2017 and 2019. Similar trends were seen in New Zealand but not the United States or United Kingdom. The RSV of typical FM symptoms including 'pain', 'muscle ache' and 'poor sleep' remained stable throughout 2020. Increases in search volumes for 'extreme fatigue' were seen in February and September to November. Significant increases in the positive control terms occurred in March, coinciding with a rapid rise in COVID-19 cases, but negative and positive controls otherwise remained similar to previous years. Conclusion: Despite public health social distancing restrictions and high COVID-19 case numbers, infodemiology techniques did not detect any increase in fibromyalgia-related searches. This occurred despite seasonal variation in ' fibromyalgia ' searches in Southern Hemisphere countries and marked changes in positive control search terms. A large increase in disease activity appears not to have emerged, and patients with fibromyalgia and ' fibromyalgianess ' may have demonstrated surprising resilience during the COVID-19 pandemic.