Coronavirus disease 2019 (COVID-19) an emerging trigger for primary fibromyalgia syndrome: A tale of three cases post-COVID-19

Abstract

Background: Corona virus (COVID-19) is an emerging worldwide infectious disease that may be followed in some patients by post COVID-19 syndrome; patients who experience symptom of disease long time after their recovery. Among the frequent post-COVID-19 symptoms are fatigue, headache, sleep disorder, anxiety and musculoskeletal pain which coincide with features of Fibromyalgia Syndrome (FMS). This study reports out of the ordinary scenarios and outcomes for three cases who developed primary FMS post COVID-19. Method: Three females, not known to have previous FMS or any other rheumatic disease, post COVID-19 were referred for rheumatology consultation due to the prolonged persistence of symptoms after recovery from COVID-19. Results: The cases presented with anxiety and depression, headache, generalized musculoskeletal pain, paresthesia and non-restorative sleep. General examination and various laboratory investigation including autoimmune profile as well as radiological investigation were all normal. Tender points on examination lead to the diagnosis of FMS. Non-pharmacological and pharmacological management with antidepressant therapy were prescribed with improvement. Conclusions: We are presenting the first three cases of COVID-19 infection as an emerging trigger for FMS. This association should be considered during management of post COVID-19 syndrome to improve pain care and prevent worsening of symptom during the COVID-19 pandemic.