Post-COVID-19 syndrome and fibromyalgia

A growing body of evidence is suggesting the possible subacute and long-term effects in patients suffering from COVID-19, affecting multiple organ systems. During acute COVID-19, musculoskeletal pain is reported in one-third of patients and it may be also part of the spectrum of post-COVID-19 syndrome, along with other manifestations. Musculoskeletal pain is the cardinal symptoms of fibromyalgia. In this context, the role of viral infection as a triggering factor for the development of fibromyalgia has been postulated since many years. Thus, the occurrence of post-COVID-19 fibromyalgia may be postulated. Several COVID-19-specific mechanisms may contribute to the pathophysiology of the subsequent musculoskeletal syndrome, such as a small fiber neuropathy, an autonomic dysfunction, and an immunological derangement. Finally, the possible multiple components of the pathogenesis and maintenance of post-COVID-19 fibromyalgia may necessitate a multimodal treatment approach.