COVID-19 Infection Linked to Rise in Chronic Fatigue Syndrome
An Increase in ME/CFS cases following the pandemic has been linked to SARS-CoV-2 infection.

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Long COVID refers to a diverse group of symptoms including fatigue, brain fog and dizziness that can persist in people who have recovered from infection with SARS-CoV-2, the virus that causes COVID-19. These symptoms are consistent with those typical of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), however, until now a direct link between SARS-CoV-2 infection and ME/CFS hadn’t been drawn.
New findings from the National Institutes of Health’s (NIH) Researching COVID to Enhance Recovery (RECOVER) Initiative suggest that SARS-CoV-2 infection may be associated with an increased risk of ME/CFS.
The research, published in the Journal of General Internal Medicine, found that 4.5% of post-COVID-19 participants enrolled in the RECOVER-adult study met ME/CFS diagnostic criteria, compared to 0.6% of participants who had not been infected by SARS-CoV-2.
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Subscribe for FREE“We have known for a long time that ME/CFS can be triggered by infection and have considered ME/CFS as the prototypical infection-associated chronic condition,” Dr. Suzanne D. Vernon, lead author and research director at the Bateman Horne Center, told Technology Networks. “The COVID-19 pandemic provided an unprecedented opportunity to determine the rate and understand the natural history of post-COVID-19 ME/CFS.”
Incident cases of ME/CFS are 15 times higher than pre-pandemic levels
Included in the analysis were 11,785 participants who had been infected by SARS-CoV-2 and 1,439 participants who had not been infected by the virus. The researchers applied the IOM clinical diagnostic criteria for ME/CFS to determine the incidence rate of post-COVID ME/CFS and to compare the occurrence of new-onset ME/CFS in participants with and without SARS-CoV-2 infection.
The findings add to growing evidence that infections, including those caused by SARS-CoV-2, can lead to ME/CFS.
“The severity of acute infection with both viral and nonviral agents is known to increase the risk for ME/CFS,” explained Vernon. “That has been shown following infection with Epstein-Barr virus, West Nile virus, and SARS, so it is (unfortunately) not surprising that there is a significantly increased rate of ME/CFS following SARS-CoV-2 infection given the vast number of people that got sick with COVID-19.”
ME/CFS and long COVID
ME/CFS is a complex, chronic condition that is estimated to affect 1.3% of adults in the US. Typical symptoms include activity-limiting fatigue, worsening of symptoms after activity (post-external malaise), cognitive impairment and dizziness when standing (orthostatic intolerance). People suffering from long COVID often report some or all of these symptoms. The study found that 88.7% of participants with post-COVID-19 ME/CFS also met RECOVER criteria for long COVID.
“This study has increased awareness of ME/CFS as a post-infectious sequela of COVID-19 within the RECOVER and beyond,” said Vernon. “Because post-COVID-19 ME/CFS is a severe subgroup of the much larger long COVID population being studied by RECOVER, the link between ME/CFS and SARS-CoV-2 will be further investigated by RECOVER as well as other NIH-funded programs.”
Limitations of the study stem from the difficulty in diagnosing a true positive ME/CFS case due to symptoms of the condition often varying in frequency and severity. In addition, the study relied on self-reported symptoms and excluded RECOVER participants who had been hospitalized.
When discussing how this may have impacted the study, Vernon stated, “The ME/CFS clinical diagnostic criteria are a constellation of pathognomonic symptoms that must be present at least half the time and are moderate to severe. We were not able to assess the frequency and severity of post-exertional malaise and orthostatic tolerance, and this may have affected the rate of post-COVID-19 ME/CFS.”
These findings highlight the need for further research to understand why some people may be more likely to develop ME/CFS following SARS-CoV-2 infection than others.
Vernon concluded, “RECOVER included people who enrolled with acute SARS-CoV-2 infection and were followed for at least 3 years. The acute infected participants that developed ME/CFS, or the incident cases of ME/CFS, could be the key to understanding why people develop ME/CFS after infection. As tragic as the COVID-19 pandemic is, it provides RECOVER and the research community an unprecedented opportunity to study the natural history of post-COVID-19 ME/CFS.”
Reference: Vernon SD, Zheng T, Do H, 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
About the interviewee:

Dr. Suzanne D. Vernon is a virologist who has dedicated her career to understanding the chronic consequences of acute viral infection. Her clinical research with the Bateman Horne Center has focused on developing objective clinical outcome assessments of ME/CFS for use in both clinical care and clinical trials. This includes point-of-care cognitive and orthostatic assessments as well as the development of digital health technologies that will passively and objectively clinically meaningful measures of ME/CFS.
Vernon’s career began at the U.S. Centers for Disease Control where she researched human papillomavirus and published some of the first papers showing higher rates of cervical cancer in HIV-infected women. She also published one of the first papers to show that one of the HIV proteins could activate human papillomavirus to turn on its cancer-causing genes. Vernon co-authored a landmark paper that determined that the severity of acute infection - rather than the type of pathogen - was the strongest predictor for developing chronic sequelae and disability. Vernon has co-authored more than 150 scientific papers and with this knowledge, aims to improve the health and lives of all people living with ME/CFS.