Association of search query interest in fibromyalgia and its symptoms during the COVID-19 pandemic in Australia: An infodemiology study

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.