What to Know About Fibromyalgia and COVID-19

Risks, Impacts, and Long-Term Similarities

In This Article

If you have fibromyalgia, COVID-19 may seem especially frightening to you. You hear people with underlying health issues are hit hardest, and you look at COVID-19 symptoms and wonder how you’ll even know if you have it.

You may also wonder, should you contract it, whether you’ll be one of the “long-haulers”—people for whom COVID-19 symptoms linger for months.

As you may expect, researchers haven’t yet examined fibromyalgia-specific risks and impacts of COVID-19. However, some information is beginning to emerge, and some can be extrapolated based on what we know of fibromyalgia and viruses similar to the novel coronavirus behind the pandemic.

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 on immunosuppressants for an autoimmune disease, you may be at higher risk both of contracting the virus and having more severe symptoms.

That doesn’t mean, though, that you should stop taking your medications. Be sure to talk to your doctor and weigh the risks and benefits before making any decisions.

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

Immune Involvement in Fibromyalgia

Many people believe fibromyalgia is an autoimmune disease. Thus far, it’s not classified as one, although some evidence suggests that some cases may have an autoimmune component.

Even so, doctors don’t generally prescribe immunosuppressants for fibromyalgia, and it’s the immunosuppression that causes the increased 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 to be an over-active immune system, not an under-active one that leaves you vulnerable to every bug that comes along.

Prevalence

Early on, at least, 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 in February through March of 2020. Of more than 74,000 people, only seven reported having fibromyalgia.

While more recent prevalence rates aren’t out yet, fibromyalgia has not emerged as one of the conditions doctors 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 lay you out with increased pain, fatigue, fibro fog, and more. 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. Keep meals on hand that are simple to prepare, don’t let yourself run out of medications, and make sure you’re stocked up on basics, like toilet paper (now that it’s available again).

Anxiety

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

Researchers launched a study into whether people with fibromyalgia were seeking treatment more often during lockdown because of anxiety-related symptom exacerbation. They concluded the study in June 2020, but as of September 2020, the results were not yet published.

A study after the terrorist attacks of September 11, 2001, suggested that the stress of a major event without a direct personal impact on daily life didn’t appear to cause the type of anxiety that leads to fibro flares.

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

And that’s not even taking into account your fears about contracting the virus or what you may go through if you or someone you know does test positive or become symptomatic.

If you think anxiety is taking a toll on you, talk to your doctor 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 through this with fewer symptom flares.

Recognizing COVID-19 Symptoms

When you look at a COVID-19 symptom list and see fatigue, body aches, headaches, brain fog, depression, and insomnia, you may think, “I live with those every day, how would I even know if I had this?”

While there is considerable overlap, some of the common symptoms of COVID-19 aren’t associated with fibromyalgia, including:

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

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

COVID-19 Long-Haulers

Some people who get sick with COVID-19 are experiencing symptoms that linger for months afterward. The term “long-haulers” has crept up for this group.

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)—and it’s long been suspected that these conditions could be triggered by certain viruses. 

That’s 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 they could see disease stressors (job loss, isolation, fear, less access to doctors or medications) that 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 also is 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 had more attention from researchers than fibromyalgia has. 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 doctors 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:

  • Hyperalgesia: Amplification of pain signals by the central nervous system
  • Allodynia: Pain from stimuli that shouldn't hurt, such as light pressure or a cold breeze on the skin
  • Paresthesia: Abnormal nerve sensations (e.g., electric-feeling zings, tingling, burning) that can range from annoying to severely painful

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’s no evidence to suggest that you’re at risk for severe symptoms, either.

In case you do get sick from it, be prepared for a flare so you’re not caught without essentials like food and medication.

If you start having symptoms like a cough and fever that could be COVID-19, call your doctor 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.

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