Hidden Pandemic After COVID-19 With 1 In 22 Survivors At High Risk Of Chronic Syndrome

Imagine fighting a virus only to find yourself in a silent, lifelong battle afterward. For many COVID-19 survivors, this nightmare is real, as 1 in 22 develops myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This hidden pandemic of exhaustion, brain fog, and unrelenting fatigue sheds light on a growing health crisis desperately seeking attention and solutions.

As the world continues to grapple with the aftermath of the COVID-19 pandemic, an emerging health crisis is taking shape in its shadow. Known as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), this complex and often misunderstood condition is increasingly being linked to SARS-CoV-2 infections. Recent research highlights that about 1 in 22 COVID-19 survivors face a significantly higher risk of developing ME/CFS, sparking concerns about a hidden pandemic of chronic illness.

Myalgic encephalomyelitis/chronic fatigue syndrome is an illness characterized by profound fatigue, unrefreshing sleep, cognitive impairment-a phenomenon often described as brain fog-and post-exertional malaise (PEM), where symptoms worsen after mental or physical exertion. Some patients with ME/CFS develop orthostatic intolerance, or the sudden drop in blood pressure when standing, further complicating their lives. Such severe cases may leave patients housebound.

A biological disorder, once labeled as a psychological condition, has now been proven to be something else. Though the exact mechanism is still not known, it does not have any FDA-approved treatments.

Recently published in the Journal of General Internal Medicine, the study reveals that COVID-19 might be connected to ME/CFS. For this purpose, researchers analyzed the data of 11,785 U.S. adults who have contracted COVID-19 and then compared them to 1,439 individuals without any infection.

The findings were striking:

- Compared with uninfected individuals, the odds of COVID-19 survivors meeting diagnostic criteria for ME/CFS at 6 months after infection were 7.5 times greater.

- ME/CFS was diagnosed in around 4.5% of COVID-19 survivors, versus 0.6% among those who did not experience a history of infection.

- Long COVID symptoms were found to overlap considerably and were reported in 88.7% of people with ME/CFS after a history of infection with COVID-19.

These findings highlight the frightening fact that COVID-19 can potentially be a primary cause of new cases of ME/CFS and add another layer of complexity to the long-term health consequences of the pandemic.

Why ME/CFS is So Challenging to Diagnose and Treat

One of the biggest challenges in dealing with ME/CFS is its diagnostic complexity. Symptoms often overlap with other conditions, and there are no definitive biomarkers to confirm the diagnosis. This has historically led to underdiagnosis or misdiagnosis.

Another point is that what causes ME/CFS is unknown. Though it has been established that infections such as SARS-CoV-2, Epstein-Barr virus, and Coxiella burnetii can provoke the condition, the pathways leading to the exact triggering are still being researched. Increasing evidence points toward the involvement of immune system imbalance, genetic factors, and impairment in energy metabolism.

Who is Most Risk?

Some groups of people are at higher risk than others:

• Women are more likely to contract ME/CFS than men, two to four times in most cases.
• The condition is diagnosed most among adolescents and young adults.
• ME/CFS may be caused by genetic factors since its development is likely if there is a family history of the disease.
• Adolescents with joint hypermobility are at an increased risk for ME/CFS, although it is not well understood.

Can CFS be treated?

While there is not a cure, many symptom-management approaches can make life dramatically better for persons affected by this condition. People with ME/CFS are given medication to assist in the resolution of headache, persistent pain, and trouble concentrating among other symptoms. Gentle manual technique by physical therapists helps to improve ease of movement and reduce both muscle and joint tension.

Activity management is another cornerstone of treatment, involving a delicate balance of rest and activity to avoid exacerbating symptoms, a common challenge for ME/CFS patients. Light aerobic exercise, when closely monitored, may be used to maintain physical fitness without exacerbating symptoms.

Psychological support is also equally important, through counseling and therapy, to alleviate the psychosocial burden of chronic disease. Sessions with a counselor or therapist will help the patients to cope with anxiety and depression often associated with ME/CFS.

Ultimately, an individualized approach is essential since the condition varies widely in its severity and triggers from one patient to another.

Are Long COVID and ME/CFS Two Sides of the Same Coin?

Long COVID shares a huge overlap with ME/CFS, leading researchers to investigate whether these are different presentations of a larger syndrome triggered by infection or other major health events. Similar symptoms such as fatigue, brain fog, and PEM point toward a common underlying mechanism though further research is needed to confirm this hypothesis.

The sobering reminder that the hidden pandemic of ME/CFS speaks to the far-reaching consequences of COVID-19. With millions of survivors at risk, the need for awareness, research, and compassionate care has never been greater. As we learn more about this complex condition, addressing it will require a concerted effort from the global healthcare community and society at large. Only then can we hope to alleviate the burden of this chronic illness and improve the lives of those affected.

Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study. BMJ. 2006

Incidence and Prevalence of Post-COVID-19 Myalgic Encephalomyelitis: A Report from the Observational RECOVER-Adult Study. J GEN INTERN MED. 2025