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The relationship between COVID-19 and fibromyalgia syndrome: prevalence, pandemic effects, symptom mechanisms, and COVID-19 vaccines

  • Perspectives in Rheumatology
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Abstract

On March 11, 2020, the World Health Organization, realizing the level of spread worldwide and the severity of the condition, accepted coronavirus disease 19 (COVID-19) as a pandemic. Subsequently, quarantine conditions were implemented around the world, and these triggered particular results. Like all other individuals, fibromyalgia syndrome (FMS) patients were affected by these conditions. The stress load in pandemic conditions, difficulties in accessing healthcare services, changes in exercise compliance, variations in physiotherapy programs, and remote work conditions all had an impact on FMS patients. Although general expectations were negative, some FMS patients were able to manage the pandemic conditions and even turn them in their favor. This is thought to be due to this patient group having established strategies to cope with stress in the pre-pandemic period, and they had sufficient ability to adapt to changing situations. FMS-related symptoms occur in a subset of individuals following COVID-19. One of the factors is the increased psychological burden after COVID-19. There is evidence that neuroinflammatory pathways affect neuroplasticity in the central nervous system and trigger the onset of FMS-related symptoms. Among the probable mechanisms are alterations in inflammatory and anti-inflammatory pathways. Changes in the autonomic nervous system with the effect of SARS-CoV-2 may induce the emergence of FMS-related symptoms. FMS and COVID-19 can coexist, and FMS may create a tendency to vaccine hesitancy. Future studies should focus on elucidating FMS-related symptoms occurring post-COVID-19. There is a need to determine distinctions between the FMS clinical status that emerged following COVID-19 and the regular patient group in terms of diagnosis, treatment, and follow-up.

Key Points

• Conflicting results have been observed in studies investigating the impacts of COVID-19 on FMS patients. In addition to studies revealing unfavorable effects, there are also articles reporting a steady course and even positive impacts.

• No significant difference was detected between the groups with and without a diagnosis of FMS in terms of hospitalization and mortality outcomes related to COVID-19.

• Several mechanisms have been proposed to explain the onset of FMS-related symptoms following COVID-19. During periods of lock-down and self-isolation, individuals are influenced biopsychosocially. Activation of some inflammatory pathways, changes in plasticity-central sensitization, and alterations in pain pathways are also plausible explanations.

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  1. Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey

    Burhan Fatih Kocyigit

  2. Physiotherapy and Rehabilitation Application and Research Center, Hasan Kalyoncu University, Gaziantep, Turkey

    Ahmet Akyol

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Study design: BFK and AA.

Data acquisition and review of the literature: BFK and AA.

Making interpretations: BFK and AA.

Drafting the manuscript: BFK.

Critically reviewing the manuscript: BFK and AA.

Final approval: BFK and AA.

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Correspondence to Burhan Fatih Kocyigit.

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Kocyigit, B.F., Akyol, A. The relationship between COVID-19 and fibromyalgia syndrome: prevalence, pandemic effects, symptom mechanisms, and COVID-19 vaccines. Clin Rheumatol 41, 3245–3252 (2022). https://doi.org/10.1007/s10067-022-06279-9

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