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      Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey

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          Abstract

          Objective

          Postacute COVID-19 syndrome (PACS) is an emerging entity characterised by a large array of manifestations, including musculoskeletal complaints, fatigue and cognitive or sleep disturbances. Since similar symptoms are present also in patients with fibromyalgia (FM), we decided to perform a web-based cross-sectional survey aimed at investigating the prevalence and predictors of FM in patients who recovered from COVID-19.

          Methods

          Data were anonymously collected between 5 and 18 April 2021. The collection form consisted of 28 questions gathering demographic information, features and duration of acute COVID-19, comorbid diseases, and other individual’s attributes such as height and weight. The American College of Rheumatology (ACR) Survey Criteria and the Italian version of the Fibromyalgia Impact Questionnaire completed the survey.

          Results

          A final sample of 616 individuals (77.4% women) filled the form 6±3 months after the COVID-19 diagnosis. Of these, 189 (30.7%) satisfied the ACR survey criteria for FM (56.6% women). A multivariate logistic regression model including demographic and clinical factors showed that male gender (OR: 9.95, 95% CI 6.02 to 16.43, p<0.0001) and obesity (OR: 41.20, 95% CI 18.00 to 98.88, p<0.0001) were the strongest predictors of being classified as having post-COVID-19 FM. Hospital admission rate was significantly higher in men (15.8% vs 9.2%, p=0.001) and obese (19.2 vs 10.8%, p=0.016) respondents.

          Conclusion

          Our data suggest that clinical features of FM are common in patients who recovered from COVID-19 and that obesity and male gender affect the risk of developing post-COVID-19 FM.

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          Most cited references41

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            Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review

            The coronavirus disease 2019 (COVID-19) pandemic, due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a worldwide sudden and substantial increase in hospitalizations for pneumonia with multiorgan disease. This review discusses current evidence regarding the pathophysiology, transmission, diagnosis, and management of COVID-19.
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              Post-acute COVID-19 syndrome

              Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.
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                Author and article information

                Journal
                RMD Open
                RMD Open
                rmdopen
                rmdopen
                RMD Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2056-5933
                2021
                23 August 2021
                23 August 2021
                : 7
                : 3
                : e001735
                Affiliations
                [1 ]departmentMedicine and Rheumatology Unit , IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
                [2 ]departmentDepartment of Biomedical and Neuromotor Sciences (DIBINEM) , Alma Mater Studiorum University of Bologna , Bologna, Italy
                [3 ]departmentDepartment of Experimental, Diagnostic and Specialty Medicine , IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi , Bologna, Italy
                [4 ]departmentClinical Trial Centre , IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
                [5 ]departmentRisk Management Unit , ASL 5 La Spezia , La Spezia, Italy
                [6 ]departmentDepartment of Experimental and Clinical Medicine , Magna Graecia University of Catanzaro , Catanzaro, Italy
                [7 ]departmentDepartment of Biotechnological and Applied Clinical Sciences , Università degli Studi dell'Aquila , L'Aquila, Italy
                [8 ]departmentDiagnostic and Interventional Radiology , IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
                [9 ]departmentDepartment of Morphology, Surgery and Experimental Medicine , University of Ferrara , Ferrara, Italy
                [10 ]departmentBiomedical Science and Technology Unit , IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
                [11 ]departmentDepartment of Medical and Surgical Sciences , Alma Mater Studiorum University of Bologna , Bologna, Italy
                [12 ]departmentDepartment of Oncological and Degenerative Spine Surgery , IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
                [13 ]departmentAcademic Rheumatology Centre, MFRU and Dipartimento Scienze Cliniche e Biologiche , Università degli Studi di Torino , Torino, Italy
                [14 ]departmentUnit of Allergology, Immunology, Rheumatology, Department of Medicine , Università Campus Bio-Medico di Roma , Roma, Italy
                [15 ]department1st Orthopaedic and Traumatologic Clinic , IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
                [16 ]departmentScientific Direction , IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
                [17 ]departmentDepartment of Biomedical and Neuromotor Sciences , University of Bologna , Bologna, Italy
                Author notes
                [Correspondence to ] Professor Francesco Ursini; francesco.ursini2@ 123456unibo.it
                Author information
                http://orcid.org/0000-0001-8194-8642
                http://orcid.org/0000-0001-5216-5219
                Article
                rmdopen-2021-001735
                10.1136/rmdopen-2021-001735
                8384499
                34426540
                92be93d3-216b-4d1d-a8dc-c1f9f8b66ad5
                © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 18 May 2021
                : 02 August 2021
                Categories
                Infections
                1506
                2474
                Original research
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                covid-19,fibromyalgia,health services research
                covid-19, fibromyalgia, health services research

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