What to Know About Fibromyalgia and COVID-19

Risks, Impacts, and Long-term Similarities

Fibromyalgia does not appear to be a risk factor for severe COVID-19. If you also have an overlapping autoimmune condition such as rheumatoid arthritis, however, you may be at greater risk for severe disease.

This is because the immunosuppressants often prescribed for these conditions can make you more susceptible to COVID-19.

This article explains which conditions appear to make COVID-19 more severe, and fibromyalgia isn't one of them. It also discusses fibromyalgia flares, how to recognize COVID-19 symptoms, and how some of them overlap with those of fibromyalgia.

The unknown risks of COVID-19 for people with fibromyalgia cause worry
ArtistGNDphotography / iStock / Getty Images

COVID-19 Risk

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:

If you're concerned about your risk, be extra diligent with the preventive measures: masks, handwashing, and social distancing.

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.

This doesn’t mean 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.

Immune Involvement in Fibromyalgia

Fibromyalgia is poorly understood. Thus far, it's not classified as an autoimmune disease, where your immune system attacks healthy cells by mistake, although evidence suggests that it may have an autoimmune component.

Even so, immunosuppressants prescribed for other autoimmune disorders are ineffective for fibromyalgia, so healthcare providers don't generally prescribe them for fibromyalgia. It’s really the immunosuppression that may sometimes increase the 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 that an overactive immune system, not an underactive one, leaves people vulnerable to every bug that comes along.

Prevalence

Early on in the pandemic, 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 from February through March of 2020. Of more than 7,000 people, only seven reported having fibromyalgia.

This trend appears to be continuing: 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.

Fibromyalgia Flares

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 cause increased pain, fatigue, and fibro fog, or the feeling of being lost. 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:

  • Store ingredients for simple-to-prepare meals.
  • Keep an ample supply of your medications on hand.
  • Remain stocked up on basics (like toilet paper) and other commodities you need.

Anxiety

Anxiety is a common symptom in fibromyalgia and one that can be crippling at times. An anxiety attack and general stress can trigger flares. And the rollercoaster nature of COVID-19 is providing ample opportunities for both.

Look back to September 11, 2001, and an ensuing study for a tantalizing clue. The study suggested that people with fibromyalgia felt no extra anxiety from the terrorist attacks because the attacks, while traumatic on the psyche, didn't have a "direct personal impact" on people's daily lives.

The ongoing situation with COVID-19 has some significant differences to keep in mind. Lockdowns, furloughs, unemployment, periods without access to healthcare providers, possible medication shortages, and even the inability to find toilet paper can have a significant impact on daily life.

In other words, it's safe to assume that COVID-19 has intensified the natural feeling of anxiety that people with fibromyalgia normally feel. And it's probably worse for people who have contracted the virus or know someone who has been hospitalized for or perished from COVID-19.

Anxiety Warrants Attention

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 your anxiety under control with fewer symptom flares.

Recognizing COVID-19 Symptoms

When you look at a COVID-19 symptom list and see fatigue, headaches, and sleep problems, you may think, “I live with these symptoms every day. How would I even know if I have COVID?”

While you're correct about the overlap, some COVID symptoms are not associated with fibromyalgia, including:

  • Chills
  • Congestion or runny nose
  • Cough
  • Fever
  • Sore throat

Being on alert for these tell-tale signs can help you distinguish between your typical symptoms and a possible coronavirus infection.

COVID-19 Long-Haulers

Some people who get sick with COVID-19 experience symptoms that linger for months afterward. They are called “long-haulers” because they deal with symptoms for the long haul.

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). Researchers have long suspected that these conditions are triggered by certain viruses.

This has 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 disease stressors (job loss, isolation, fear, less access to healthcare providers or medications) could 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 is also 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 generated more attention from researchers than fibromyalgia. 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.

OVERLAPPING SYMPTOMS
Symptoms Long-haul Fibromyalgia
Fatigue
Malaise
Cough  
Headaches
Body aches
Fever  
Chills  
Lost sense of smell, taste
Diarrhea ✔*
Congestion  
Shortness of breath
Nausea ✔*
Sore throat  
Chest pain ✔**
Abdominal pain
Immune-system damage
Neuroinflammation
Brain/nervous system abnormalities
Cognitive dysfunction
Depression
Insomnia
Impaired blood-sugar regulation
Organ damage  
*Due to overlapping IBS **Due to overlapping costochondritis

What remains to be seen is whether COVID-19 long-haulers will develop the abnormal pain types of fibromyalgia, which include:

  • Allodynia: Pain from stimuli that shouldn't hurt, such as subtle pressure or a cold breeze on the skin
  • Hyperalgesia: Amplification of pain signals by the central nervous system
  • Paresthesia: Abnormal nerve sensations (e.g., electric-like zings, tingling, and 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.

Doctor Discussion Guide Old Man

Summary

Fibromyalgia is not on the list of pre-existing conditions that appear to make COVID-19 more severe. Put another way, 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. The key issue for people with fibromyalgia is identifying the difference between fibromyalgia symptoms and virus symptoms because the two can overlap. In this case, it's a good thing that some COVID symptoms are not associated with fibromyalgia, including chills, congestion or a runny nose, cough, fever, and sore throat.

A Word From Verywell

If you aren’t being treated with immunosuppressants, your fibromyalgia shouldn’t put you at high risk for catching COVID-19. There is no evidence to suggest that you’re at risk for severe symptoms, either. Still, if you begin to have symptoms associated with 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

  • 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 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.

The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.