If you’re constantly tired, even after a good night’s sleep, scientists believe there could be a little-understood reason.
For the first time, scientists funded by the NIH have found chronic fatigue syndrome (CFS) is seven and a half times more common in people who have been infected with Covid.
Around one in 20 Americans who had the virus suffer from the condition, which causes exhaustion after doing simple tasks, orthostatic intolerance (dizziness when standing), unrefreshing sleep, cognitive impairment, and fatigue.
Given that virtually every American has had Covid, the researchers said there could be millions of new cases of chronic fatigue syndrome going undiagnosed.
There is no cure for chronic fatigue, but doctors can try a series of medications to target symptoms, including antidepressants and mood stabilizers, as well as physical and talk therapy.
Chronic fatigue syndrome is diagnosed by a doctor through a review of your medical history, a physical examination, and by ruling out other possible conditions. Currently, no single test can definitively diagnose the condition.
The researchers found Covid infections may increase the odds of developing chronic fatigue syndrome.
Dr Suzanne Vernon, research director at the Bateman Horne Center and lead author, said: ‘This research underscores the urgency for healthcare providers to recognize post-COVID-19 ME/CFS.
‘Early diagnosis and proper management can transform lives.’
The most common symptom was post-exertional malaise (PEM), reported by nearly 16 percent of acute infected patients and 29 percent of people who had recovered from infection
An estimated 3.3 million Americans have chronic fatigue syndrome, also called myalgic encephalomyelitis (ME) a lasting disorder that causes exhaustion, brain fog, and pain for six months or more.
The research was part of the NIH’s Researching COVID to Enhance Recovery (RECOVER) Initiative aimed at better understanding, diagnosing, and treating long Covid.
Chronic fatigue is believed to be the result of the body fighting all-out against an infection, causing the immune system to go into overdrive, and then staying in overdrive when it no longer needs to be.
Around 11,800 people included in the study had been infected with Covid while slightly more than 1,400 had not.
Researchers issued questionnaires every three months from October 2021 to September 2024.
Of the people who had been infected, 4.5 percent fit the bill for chronic fatigue syndrome, compared to 0.6 percent of patients that had not been infected with Covid.
Nearly 40 percent were ‘ME/CFS-like,’ meaning they had at least one symptom of the condition, and approximately 56 percent did not report any fatigue symptoms.
Forty-five percent of individuals who met the criteria for chronic fatigue were also identified as some of the most symptomatic long Covid patients, underscoring the overlap between the two conditions.
The most common symptom was post-exertional malaise (PEM), reported by nearly 16 percent of infected patients and 29 percent of people who had recovered from infection.
Chronic fatigue syndrome is a life-altering condition. Around 75 percent of people who have it are unable to work
Orthostatic intolerance (dizziness when standing) was the second most common, with 14 percent of infected and 25 percent of post-infected reporting it.
Other symptoms like unrefreshing sleep, cognitive impairment, and fatigue were more common in post-infected participants. All symptoms were less frequent in uninfected participants compared to those who had been infected.
The research was published in the Journal of General Internal Medicine.
The prevalence of chronic fatigue could be increasing, the researchers said, noting that before the pandemic, an estimated 0.2 percent to one percent of Americans were living with CFS.
A nationwide survey conducted throughout 2021 found about 1.3 percent of American adults had been diagnosed with chronic fatigue syndrome by a doctor, which suggested to researchers that post-COVID cases of CFS may already be raising the number of people affected nationwide.
Fatigue is common among people suffering from long Covid, an amorphous condition made up of a constellation of symptoms from brain fog and fatigue to heart inflammation and joint pain.
It is a life-altering condition. Around 75 percent of people who have it are unable to work.
CFS causes fatigue, sleep disturbances, brain fog/difficulty thinking, dizziness and orthostatic intolerance (the medical term for when standing up causes symptoms), headaches, muscle weakness and pain, and more.
It can be difficult to diagnose because symptoms can change in how frequently they occur and how severe they are can shift over time.
The most common symptom is post-exertional malaise, or the worsening of symptoms after doing something physical or mental.
Everyday activities like showering, driving, reading, and even talking can trigger PEM, making normal tasks exponentially harder.
ME/CFS is still understood as a multisystem condition that impacts various parts of the body. However, the pandemic has increased focus on how Covid can trigger or worsen it.
Several studies have highlighted an overlap in symptoms reported by patients with Long COVID and ME/CFS.
An estimated 17 million Americans have long Covid, which manifests differently in each person.
Some people may only experience shortness of breath and fatigue, while others may only experience brain fog and difficulty concentrating.
Because of this, diagnosing long Covid is challenging.
Two years ago, American, Danish, and British researchers concluded that long Covid has been ‘greatly exaggerated.’ Soon after, another UK-based scientist acknowledged that the condition is real but argued that more patients have been labeled with it than actually have it.
Last week, a new study found some patients given a 15-day course of Paxlovid – the medication used to treat Covid – had significant improvements to symptoms that had plagued them for years.
Five out of 13 patients – 38 percent – showed sustained improvement, but nearly everyone benefitted temporarily.
Dr Michael Peluso, lead investigator at UCSF’s long Covid research program, said: ‘If we’ve learned one thing over the last four years, it’s that long COVID is complex, and figuring out why some people benefit so remarkably from antiviral treatment while others don’t is one of the most important questions for the field.
‘We are going to need to embrace that complexity to get answers for the millions of people suffering from this condition.’
