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Original research
Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey
  1. Francesco Ursini1,2,
  2. Jacopo Ciaffi1,
  3. Luana Mancarella1,
  4. Lucia Lisi1,
  5. Veronica Brusi1,
  6. Carlotta Cavallari1,
  7. Martina D’Onghia1,
  8. Anna Mari1,
  9. Elena Borlandelli3,
  10. Jacopo Faranda Cordella4,
  11. Micaela La Regina5,
  12. Pasquale Viola6,
  13. Piero Ruscitti7,
  14. Marco Miceli8,
  15. Roberto De Giorgio9,
  16. Nicola Baldini10,
  17. Claudio Borghi11,
  18. Alessandro Gasbarrini12,
  19. Annamaria Iagnocco13,
  20. Roberto Giacomelli14,
  21. Cesare Faldini15,
  22. Maria Paola Landini16 and
  23. Riccardo Meliconi1,17
  1. 1Medicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  2. 2Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
  3. 3Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Bologna, Italy
  4. 4Clinical Trial Centre, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  5. 5Risk Management Unit, ASL 5 La Spezia, La Spezia, Italy
  6. 6Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
  7. 7Department of Biotechnological and Applied Clinical Sciences, Università degli Studi dell'Aquila, L'Aquila, Italy
  8. 8Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  9. 9Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
  10. 10Biomedical Science and Technology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  11. 11Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
  12. 12Department of Oncological and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  13. 13Academic Rheumatology Centre, MFRU and Dipartimento Scienze Cliniche e Biologiche, Università degli Studi di Torino, Torino, Italy
  14. 14Unit of Allergology, Immunology, Rheumatology, Department of Medicine, Università Campus Bio-Medico di Roma, Roma, Italy
  15. 151st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  16. 16Scientific Direction, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  17. 17Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
  1. Correspondence to Professor Francesco Ursini; francesco.ursini2{at}


Objective Postacute COVID-19 syndrome (PACS) is an emerging entity characterised by a large array of manifestations, including musculoskeletal complaints, fatigue and cognitive or sleep disturbances. Since similar symptoms are present also in patients with fibromyalgia (FM), we decided to perform a web-based cross-sectional survey aimed at investigating the prevalence and predictors of FM in patients who recovered from COVID-19.

Methods Data were anonymously collected between 5 and 18 April 2021. The collection form consisted of 28 questions gathering demographic information, features and duration of acute COVID-19, comorbid diseases, and other individual’s attributes such as height and weight. The American College of Rheumatology (ACR) Survey Criteria and the Italian version of the Fibromyalgia Impact Questionnaire completed the survey.

Results A final sample of 616 individuals (77.4% women) filled the form 6±3 months after the COVID-19 diagnosis. Of these, 189 (30.7%) satisfied the ACR survey criteria for FM (56.6% women). A multivariate logistic regression model including demographic and clinical factors showed that male gender (OR: 9.95, 95% CI 6.02 to 16.43, p<0.0001) and obesity (OR: 41.20, 95% CI 18.00 to 98.88, p<0.0001) were the strongest predictors of being classified as having post-COVID-19 FM. Hospital admission rate was significantly higher in men (15.8% vs 9.2%, p=0.001) and obese (19.2 vs 10.8%, p=0.016) respondents.

Conclusion Our data suggest that clinical features of FM are common in patients who recovered from COVID-19 and that obesity and male gender affect the risk of developing post-COVID-19 FM.

  • COVID-19
  • fibromyalgia
  • health services research

Data availability statement

Data are available upon reasonable request. Data are available upon request from the corresponding author.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

Data are available upon reasonable request. Data are available upon request from the corresponding author.

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  • JC and LM contributed equally.

  • Contributors FU, JC and RM conceived and designed the work, analysed the data and prepared the first draft of the manuscript; LM, LL, VB, CC, MDO, AM, EB, JFC, MLR, PV, PR and MM contributed to the acquisition of data; RDG, NB, CB, AG, AI, RG, CF and MPL contributed to the acquisition and interpretation of data; all author revised the manuscript for important intellectual content, approved the version to be published and agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.