Persistent Fibromyalgia-like symptom presentation in Long COVID-associated chronic musculoskeletal pain: a longitudinal cohort study
- 1Leeds Institute of Rheumatic and Musculoskeletal Medicine, School of Medicine, Faculty of Health and Life Sciences, University of Leeds, Leeds, UK
Abstract
BackgroundChronic musculoskeletal pain (CMP) is a common and debilitating symptom of Long COVID (LC), which shares several clinical features with Fibromyalgia Syndrome (FMS).
AimsThis longitudinal study investigated whether the symptom overlap between LC-CMP and FMS persists over time, whether patterns differ according to pre-COVID CMP history, and the extent to which neuropathic pain features are present.
MethodsIndividuals with LC completed questionnaires assessing the symptom-based component of the 2010 American College of Rheumatology criteria for FMS and the presence of neuropathic pain features (PainDetect Questionnaire, PDQ) at baseline, 6- and 12-month follow-ups. Participants were grouped according to pre-COVID CMP history. Group differences were analysed using mixed-effects logistic regression.
Results240 individuals completed the baseline assessment at a mean of 2.61 years after LC onset, including 131 (100 females) with new-onset CMP and 94 (87 females) with pre-existing CMP. The prevalence of participants meeting the symptom-based criteria for FMS remained high across follow-up (67.5-78.6%), with 50.0-61.0% of those with complete follow-up data fulfilling criteria at all timepoints. No significant subgroup differences were observed (OR = 0.43, 95% CI [0.14 1.39], p = 0.160). Across follow-up, 22.2-36.1% of participants reported likely neuropathic pain features, with significantly higher odds in the pre-existing CMP group (OR = 3.17, 95% CI [1.22 8.18], p = 0.017).
ConclusionsFMS-like symptoms remain highly prevalent several years after acute COVID-19 and persist over a further 12 months, suggesting that LC-CMP frequently represents a persistent long-term condition with substantial overlap with FMS. These findings support closer integration of LC and chronic pain rehabilitation services and add to the wider literature linking post-infectious processes with FMS-like symptoms.
Related
- Longitudinal Transcriptomic Analysis Identifies Persistent Immune-Related Signature Associated With Restrictive Left Ventricular Filling Patterns After Heart Transplantation
- Area-Level Rurality and Documented Musculoskeletal Symptom Presentation at Rheumatoid Arthritis Diagnosis Among Older Adults in Rural Japan: A Cross-Sectional Study.
- A reproducible symptom-based computational phenotyping framework for longitudinal fibromyalgia analysis using real-world registry data: a cross-cohort validation study.
- Fermented dairy intake and markers of musculoskeletal ageing on the island of Ireland: insights from the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) and The Irish Longitudinal Study on Ageing (TILDA)
- Persistent prefectural ordering of billed urinary albumin quantification in Japan: a nationwide longitudinal ecological study
BibTeX
@misc{silvapassadouro2026persistent,
title = {{Persistent Fibromyalgia-like symptom presentation in Long COVID-associated chronic musculoskeletal pain: a longitudinal cohort study}},
author = {B. Silva-Passadouro and I. Delis and S. L. Astill and C. Brown and A. J. Casson and M. Sivan},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.07.26364942},
url = {https://www.medrxiv.org/content/10.64898/2026.10.07.26364942v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Persistent Fibromyalgia-like symptom presentation in Long COVID-associated chronic musculoskeletal pain: a longitudinal cohort study
AU - B. Silva-Passadouro
AU - I. Delis
AU - S. L. Astill
AU - C. Brown
AU - A. J. Casson
AU - M. Sivan
PY - 2026
DA - 2026/10/07
PB - medRxiv
DO - 10.64898/2026.10.07.26364942
UR - https://www.medrxiv.org/content/10.64898/2026.10.07.26364942v1
AB - BackgroundChronic musculoskeletal pain (CMP) is a common and debilitating symptom of Long COVID (LC), which shares several clinical features with Fibromyalgia Syndrome (FMS). AimsThis longitudinal study investigated whether the symptom overlap between LC-CMP and FMS persists over time, whether patterns differ according to pre-COVID CMP history, and the extent to which neuropathic pain features are present. MethodsIndividuals with LC completed questionnaires assessing the symptom-based component of the 2010 American College of Rheumatology criteria for FMS and the presence of neuropathic pain features (PainDetect Questionnaire, PDQ) at baseline, 6- and 12-month follow-ups. Participants were grouped according to pre-COVID CMP history. Group differences were analysed using mixed-effects logistic regression. Results240 individuals completed the baseline assessment at a mean of 2.61 years after LC onset, including 131 (100 females) with new-onset CMP and 94 (87 females) with pre-existing CMP. The prevalence of participants meeting the symptom-based criteria for FMS remained high across follow-up (67.5-78.6%), with 50.0-61.0% of those with complete follow-up data fulfilling criteria at all timepoints. No significant subgroup differences were observed (OR = 0.43, 95% CI [0.14 1.39], p = 0.160). Across follow-up, 22.2-36.1% of participants reported likely neuropathic pain features, with significantly higher odds in the pre-existing CMP group (OR = 3.17, 95% CI [1.22 8.18], p = 0.017). ConclusionsFMS-like symptoms remain highly prevalent several years after acute COVID-19 and persist over a further 12 months, suggesting that LC-CMP frequently represents a persistent long-term condition with substantial overlap with FMS. These findings support closer integration of LC and chronic pain rehabilitation services and add to the wider literature linking post-infectious processes with FMS-like symptoms.
ER -