AN increased risk of developing myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) following SARS-CoV-2 infection has been highlighted in a new U.S. study. The Researching COVID to Enhance Recovery (RECOVER-Adult) study, one of the largest post-COVID-19 investigations to date, provides critical insights into the incidence and prevalence of this debilitating condition among adults.
The RECOVER-Adult study followed 11,785 participants across the U.S., grouping them based on their infection status and timing of enrollment. Among those infected with SARS-CoV-2, the incidence rate of ME/CFS was 2.66 per 100 person-years. In comparison, the rate among uninfected participants was significantly lower at 0.93 per 100 person-years, revealing a hazard ratio of 4.93. This data suggests that individuals recovering from COVID-19 are nearly five times more likely to develop ME/CFS than their uninfected counterparts.
Prevalence rates further emphasized this risk, with 4.5% of all infected participants meeting the Institute of Medicine’s clinical diagnostic criteria for ME/CFS, compared to just 0.6% of uninfected participants. Post-exertional malaise—a hallmark symptom of ME/CFS—was the most frequently reported symptom, affecting 24% of infected individuals.
The study also found a significant overlap between post-COVID-19 ME/CFS and long COVID diagnoses. An estimated 88.7% of participants with post-COVID ME/CFS also met the broader RECOVER criteria for long COVID. These findings underline the need for clinicians to monitor patients with lingering post-viral symptoms closely, particularly those reporting profound fatigue or exertion-related relapses.
Despite its robust dataset, the study acknowledges limitations, such as reliance on self-reported symptoms and the fluctuating nature of ME/CFS symptoms. However, it provides a vital foundation for understanding the long-term effects of SARS-CoV-2 infection, paving the way for better diagnostic and therapeutic strategies for ME/CFS.
Reference: Vernon SD et al. Incidence and Prevalence of Post-COVID-19 Myalgic Encephalomyelitis: A Report from the Observational RECOVER-Adult Study. J Gen Intern Med. 2025. doi: 10.1007/s11606-024-09290-9.
Anaya Malik | AMJ
