Long COVID versus FM/CFS/ME: overlap and differences in patient-reported burden
Abstract
Background: Long COVID shares prominent symptoms with fibromyalgia/chronic fatigue syndrome/myalgic encephalomyelitis (FM/CFS/ME), but the extent of overlap and separation in patient-reported and functional burden is still unclear. We compared both groups against recovered controls.
Methods: We performed a cross-sectional analysis of the ARALONGCOV database in Aragon, Spain, including long COVID cases, FM/CFS/ME participants and recovered controls. We compared SF-12, Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), PHQ-9 and 6-minute walk distance using available data in each domain.
Results: Both long COVID and FM/CFS/ME showed substantially worse outcomes than controls. Median SF-12 scores were 32.1 in long COVID, 20.4 in FM/CFS/ME and 87.5 in controls. Median FSS scores were 57, 61 and 6, respectively; median PSQI scores were 12, 14 and 6; median PHQ-9 scores were 12, 15 and 1; and median 6-minute walk distances were 440 m, 418 m and 541.5 m. Global between-group differences were highly significant across all domains (all p < 0.001). Compared directly with long COVID, FM/CFS/ME participants showed poorer quality of life, higher fatigue, poorer sleep, more depressive symptoms and lower exercise capacity, although both groups were markedly more impaired than controls.
Conclusions: Long COVID and FM/CFS/ME showed overlapping multidimensional burden, with FM/CFS/ME generally more severely affected. These findings support a comparative framework for studying shared and distinct mechanisms, while highlighting the substantial functional impact of long COVID in primary care.
Key messages: • Long COVID and FM/CFS/ME showed marked overlap in multidimensional burden, with both groups far more impaired than controls.
• FM/CFS/ME was generally more severely affected, supporting comparative research on shared and distinct mechanisms.
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BibTeX
@article{lermairureta2026long,
title = {{Long COVID versus FM/CFS/ME: overlap and differences in patient-reported burden}},
author = {D Lerma-Irureta and R Magallón-Botaya and F Méndez-López and B Olivan-Blázquez},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1137},
url = {https://doi.org/10.1093/eurpub/ckag169.1137},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Long COVID versus FM/CFS/ME: overlap and differences in patient-reported burden
AU - D Lerma-Irureta
AU - R Magallón-Botaya
AU - F Méndez-López
AU - B Olivan-Blázquez
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1137
UR - https://doi.org/10.1093/eurpub/ckag169.1137
AB - Background: Long COVID shares prominent symptoms with fibromyalgia/chronic fatigue syndrome/myalgic encephalomyelitis (FM/CFS/ME), but the extent of overlap and separation in patient-reported and functional burden is still unclear. We compared both groups against recovered controls. Methods: We performed a cross-sectional analysis of the ARALONGCOV database in Aragon, Spain, including long COVID cases, FM/CFS/ME participants and recovered controls. We compared SF-12, Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), PHQ-9 and 6-minute walk distance using available data in each domain. Results: Both long COVID and FM/CFS/ME showed substantially worse outcomes than controls. Median SF-12 scores were 32.1 in long COVID, 20.4 in FM/CFS/ME and 87.5 in controls. Median FSS scores were 57, 61 and 6, respectively; median PSQI scores were 12, 14 and 6; median PHQ-9 scores were 12, 15 and 1; and median 6-minute walk distances were 440 m, 418 m and 541.5 m. Global between-group differences were highly significant across all domains (all p < 0.001). Compared directly with long COVID, FM/CFS/ME participants showed poorer quality of life, higher fatigue, poorer sleep, more depressive symptoms and lower exercise capacity, although both groups were markedly more impaired than controls. Conclusions: Long COVID and FM/CFS/ME showed overlapping multidimensional burden, with FM/CFS/ME generally more severely affected. These findings support a comparative framework for studying shared and distinct mechanisms, while highlighting the substantial functional impact of long COVID in primary care. Key messages: • Long COVID and FM/CFS/ME showed marked overlap in multidimensional burden, with both groups far more impaired than controls. • FM/CFS/ME was generally more severely affected, supporting comparative research on shared and distinct mechanisms.
SN - 1101-1262
SN - 1464-360X
ER -