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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.
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.
Prevalence
Early on in the pandemic, people with fibromyalgia didn’t appear to have been hit extra hard by COVID-19. The 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.
Lockdowns, furloughs, unemployment, periods without access to healthcare providers, and possible medication shortages are just some of the factors that can have a significant impact on daily life.
And they seem to have taken a toll. One 2022 study tracked 78 people with fibromyalgia before and during the pandemic and found “significant fibromyalgia symptom deterioration” including increases in pain, anxiety, and depression.
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 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 telltale signs can help you distinguish between your typical symptoms and a possible coronavirus infection.
Long COVID
Some people who get sick with COVID-19 experience symptoms that linger for months afterward. This is commonly called long COVID, but is sometimes referred to by other names, including post-COVID condition and post-acute sequelae of SARS-CoV-2 infection.
As with the symptoms of acute disease, long COVID 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 web-based survey published in 2021 found that 31% of people with long COVID reported symptoms that meet the diagnostic criteria for fibromyalgia six months after having COVID-19. Those who had a more serious infection, such as requiring oxygen therapy or hospitalization, were more likely to develop fibromyalgia-like illness.
Similarly, 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.”
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.
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.
| OVERLAPPING SYMPTOMS | ||
|---|---|---|
| Symptoms | Long-COVID | 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 | ✔ | |
What remains to be seen is whether those with long-COVID 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 COVID Doctor Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
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Summary
Fibromyalgia is not on the list of pre-existing conditions that appear to make COVID-19 more severe. The key issue for people with fibromyalgia is identifying the difference between fibromyalgia symptoms and virus symptoms because the two can overlap. Some COVID symptoms are not associated with fibromyalgia, including chills, congestion or a runny nose, cough, fever, and sore throat.
The symptoms healthcare providers are seeing in long COVID bear a striking resemblance to fibromyalgia symptoms. Some experts predict an increase in fibromyalgia cases among those who have had COVID.
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, take a test right away (either an at-home test or in a provider’s office). If it’s positive, isolate and contact a provider or pharmacy for treatment options.
And keep up your prevention efforts by wearing a mask, washing your hands frequently, and social distancing.
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.
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