If you have fibromyalgia, COVID-19 may seem especially frightening to you. You hear people with underlying health issues are hit hardest, and you look at COVID-19 symptoms and wonder how you’ll even know if you have it.
You may also wonder, should you contract it, whether you’ll be one of the “long-haulers”—people for whom COVID-19 symptoms linger for months.
As you may expect, researchers haven’t yet examined fibromyalgia-specific risks and impacts of COVID-19. However, some information is beginning to emerge, and some can be extrapolated based on what we know of fibromyalgia and viruses similar to the novel coronavirus (SARS-CoV-2) responsible for the pandemic.
Fibromyalgia is not on the list of pre-existing conditions that appear to make COVID-19 more severe. However, some conditions that frequently overlap with fibromyalgia are, including:
- Autoimmune diseases like lupus, Sjögren’s syndrome, and rheumatoid arthritis
- Diabetes (type 2)
If you’re on immunosuppressants for an autoimmune disease, you may be at higher risk both of contracting the virus and having more severe symptoms.
That doesn’t mean, though, that you should stop taking your medications. Be sure to talk to your healthcare provider and weigh the risks and benefits before making any decisions.
If you’re concerned about your risk, be extra diligent with the preventive measures you’ve heard about—masks, handwashing, and social distancing.
Immune Involvement in Fibromyalgia
Many people believe fibromyalgia is an autoimmune disease. Thus far, it’s not classified as one, although some evidence suggests that some cases may have an autoimmune component.
Even so, healthcare providers don’t generally prescribe immunosuppressants for fibromyalgia, and it’s the immunosuppression that causes the increased risk of COVID-19.
More and more, though, fibromyalgia is being classified as a neuro-immune condition, meaning there is some immune-system dysregulation. However, it appears to be an over-active immune system, not an under-active one that leaves you vulnerable to every bug that comes along.
Early on, at least, people with fibromyalgia didn’t appear to have been hit extra hard by COVID-19. The U.S. Centers for Disease Control and Prevention (CDC) tracked underlying health conditions in people diagnosed with COVID-19 in February through March of 2020. Of more than 74,000 people, only seven reported having fibromyalgia.
While more recent prevalence rates aren’t out yet, fibromyalgia has not emerged as one of the conditions healthcare providers and hospitals are seeing in a lot of people they’re treating for COVID-19.
Just about any assault on the system of someone with fibromyalgia can lead to a flare. A stressful situation, a minor injury, or a passing illness can all lay you out with increased pain, fatigue, fibro fog, and more. It stands to reason, then, that if you do contract COVID-19, it could trigger a flare even if symptoms of the infection don’t become severe.
As always, it pays to be prepared for a flare. Keep meals on hand that are simple to prepare, don’t let yourself run out of medications, and make sure you’re stocked up on basics, like toilet paper (now that it’s available again).
Anxiety is a common symptom in fibromyalgia and one that can be crippling at times. An anxiety attack or just general stress can trigger flares, and the time of COVID-19 is providing ample opportunities for both.
Researchers launched a study into whether people with fibromyalgia were seeking treatment more often during lockdown because of anxiety-related symptom exacerbation. They concluded the study in June 2020, but as of September 2020, the results were not yet published.
A study after the terrorist attacks of September 11, 2001, suggested that the stress of a major event without a direct personal impact on daily life didn’t appear to cause the type of anxiety that leads to fibro flares.
The situation with COVID-19, though, has some important differences to keep in mind. Lockdowns, unemployment, periods without access to healthcare providers, possible medication shortages, and even the inability to find toilet paper can have a significant impact on your daily life.
And that’s not even taking into account your fears about contracting the virus or what you may go through if you or someone you know does test positive or become symptomatic.
If you think anxiety is taking a toll on you, talk to your healthcare provider about how you may be able to manage it better. Medication, supplements such as l-theanine or DHEA, and other stress-management techniques like yoga and meditation may help you get through this with fewer symptom flares.
Recognizing COVID-19 Symptoms
When you look at a COVID-19 symptom list and see fatigue, body aches, headaches, brain fog, depression, and insomnia, you may think, “I live with those every day, how would I even know if I had this?”
While there is considerable overlap, some of the common symptoms of COVID-19 aren’t associated with fibromyalgia, including:
- Sore throat
- Congestion or runny nose
Being on alert for those tell-tale signs can help you distinguish between your typical symptoms and coronavirus infection.
Some people who get sick with COVID-19 are experiencing symptoms that linger for months afterward. The term “long-haulers” has crept up for this group.
As with the symptoms of acute disease, these long-haul symptoms are strikingly similar to fibromyalgia and its close cousin myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)—and it’s long been suspected that these conditions could be triggered by certain viruses.
That’s led some researchers to wonder whether we’ll see a surge of post-viral fibromyalgia or ME/CFS cases as a result of the pandemic.
A review of early observations of COVID-19’s impact on people with autoimmunity suggested that they could see disease stressors (job loss, isolation, fear, less access to healthcare providers or medications) that lead to increases in fatigue, pain, and new cases of secondary fibromyalgia, which is especially common in autoimmune disease.
Severe acute respiratory syndrome (SARS), which also is caused by a coronavirus, led to long-term post-viral illness that, according to a 2011 study, “overlaps with the clinical and sleep features of [fibromyalgia] and chronic fatigue syndrome.”
Because it’s more closely associated with viral triggers, ME/CFS has had more attention from researchers than fibromyalgia has. However, with how closely they’re related and how similar the symptoms are, it’s possible that both conditions will see an upswing in diagnoses in the near future.
The symptoms healthcare providers are seeing in long-haulers bear a striking resemblance to fibromyalgia symptoms.
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What remains to be seen is whether COVID-19 long-haulers will develop the abnormal pain types of fibromyalgia, which include:
- Hyperalgesia: Amplification of pain signals by the central nervous system
- Allodynia: Pain from stimuli that shouldn’t hurt, such as light pressure or a cold breeze on the skin
- Paresthesia: Abnormal nerve sensations (e.g., electric-feeling zings, tingling, burning) that can range from annoying to severely painful
Long-Haul COVID Doctor Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
A Word From Get Meds Info
If you aren’t being treated with immunosuppressants, your fibromyalgia shouldn’t put you at high risk for catching COVID-19. There’s no evidence to suggest that you’re at risk for severe symptoms, either.
In case you do get sick from it, be prepared for a flare so you’re not caught without essentials like food and medication.
If you start having symptoms like a cough and fever that could be COVID-19, call your healthcare provider right away and ask whether you should get tested and/or come in for an examination. And keep up your prevention efforts by wearing a mask, washing your hands frequently, and social distancing.
Frequently Asked Questions
Do the COVID-19 vaccines work for people on immunosuppressants?
If you’re taking immunosuppressants and are immunocompromised, you’ll have a lower antibody response to the COVID vaccines. That means the shots won’t provide as much protection as they do to other people. The FDA authorized a third dose of the mRNA vaccines for certain immunocompromised people, which is believed to increase overall protection. If you’ve had the two mRNA vaccine doses, talk to your healthcare provider about whether you should receive a third dose.Learn More:Your Guide to COVID-19
How can I manage fibromyalgia symptoms with COVID lockdowns?
Studies have shown that people with fibromyalgia are struggling with anxiety and access to support systems and treatments due to COVID restrictions. Healthcare providers recommend exercise, relaxation techniques, and finding a way to connect with loved ones and a social network in order to manage anxiety, ease chronic pain and overcome fatigue.
Are people with fibromyalgia at greater risk for COVID?
Fibromyalgia itself is not considered an illness that puts you at higher risk for COVID. However, other illnesses such as diabetes and obesity that occur with fibromyalgia may make you more vulnerable.Learn More:Fibromyalgia and Obesity
U.S. Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19): People with certain medical conditions. Updated August 20, 2021.
Greenbaum H, Weil C, Chodick G, Shalev V, Eisenberg VH. Evidence for an association between endometriosis, fibromyalgia, and autoimmune diseases. Am J Reprod Immunol. 2019;81(4):e13095. doi:10.1111/aji.13095
Yanmaz MN, Mert M, Korkmaz M. The prevalence of fibromyalgia syndrome in a group of patients with diabetes mellitus. Rheumatol Int. 2012;32(4):871-874. doi:10.1007/s00296-010-1618-8
Aloush V. Fibromyalgia, obesity and all that lies in between. Harefuah. 2019;158(9):587-588.
Thng ZX, De Smet MD, Lee CS, et al. COVID-19 and immunosuppression: a review of current clinical experiences and implications for ophthalmology patients taking immunosuppressive drugs. Br J Ophthalmol. 2020;bjophthalmol-2020-316586. doi:10.1136/bjophthalmol-2020-316586
Ryabkova VA, Churilov LP, Shoenfeld Y. Neuroimmunology: What role for autoimmunity, neuroinflammation, and small fiber neuropathy in fibromyalgia, chronic fatigue syndrome, and adverse events after human papillomavirus vaccination?. Int J Mol Sci. 2019;20(20):5164. doi:10.3390/ijms20205164
Totsch SK, Sorge RE. Immune system involvement in specific pain conditions. Mol Pain. 2017;13:1744806917724559. doi:10.1177/1744806917724559
U.S. Centers for Disease Control and Prevention. Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019–United States, February 12-March 28, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:382–386. doi:10.15585/mmwr.mm6913e2
National Institutes of Health, U.S. National Library of Medicine: ClinicalTrials.gov. Fibromyalgia during the COVID-19 pandemic. Updated June 11, 2020.
Williams DA, Brown SC, Clauw DJ, Gendreau RM. Self-reported symptoms before and after September 11 in patients with fibromyalgia. JAMA. 2003;289(13):1637-1638. doi:10.1001/jama.289.13.1637
U.S. Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19): Symptoms. Updated May 13, 2020.
Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA. 2020;324(6):603-605. doi:10.1001/jama.2020.12603
Rogal SS, Bielefeldt K, Wasan AD, Szigethy E, Lotrich F, DiMartini AF. Fibromyalgia symptoms and cirrhosis. Dig Dis Sci. 2015;60(5):1482-1489. doi:10.1007/s10620-014-3453-3
Moss-Morris R, Deary V, Castell B. Chronic fatigue syndrome. Handb Clin Neurol. 2013;110:303-314. doi:10.1016/B978-0-444-52901-5.00025-3
Pope JE. What does the COVID-19 pandemic mean for rheumatology patients? Curr Treatm Opt Rheumatol. 2020;1-4. doi:10.1007/s40674-020-00145-y
Moldofsky H, Patcai J. Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study. BMC Neurol. 2011;11:37. doi:10.1186/1471-2377-11-37
American Medical Association. What to tell immunocompromised patients about COVID-19. Published August 17, 2021.
Aloush V, Gurfinkel A, Shachar N, Ablin JN, Elkana O. Physical and mental impact of COVID-19 outbreak on fibromyalgia patients. Clin Exp Rheumatol. 2021;39 Suppl 130(3):108-114.
Dasgupta A, Kalhan A, Kalra S. Long term complications and rehabilitation of COVID-19 patients. J Pak Med Assoc. 2020;70(Suppl 3)(5):S131-S135. doi:10.5455/JPMA.32
Fotuhi M, Mian A, Meysami S, Raji CA. Neurobiology of COVID-19. J Alzheimers Dis. 2020;76(1):3-19. doi:10.3233/JAD-200581
Heneka MT, Golenbock D, Latz E, Morgan D, Brown R. Immediate and long-term consequences of COVID-19 infections for the development of neurological disease. Alzheimers Res Ther. 2020;12(1):69. doi:10.1186/s13195-020-00640-3
Morlacco A, Motterle G, Zattoni F. The multifaceted long-term effects of the COVID-19 pandemic on urology. Nat Rev Urol. 2020;17(7):365-367. doi:10.1038/s41585-020-0331-y
Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network—United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69:993-998. doi:10.15585/mmwr.mm6930e1
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