Abstract

To identify predicators of patients with fibromyalgia (FM) that are associated with a severe COVID-19 disease course. We utilized the data base of the Clalit Health Services (CHS); the largest public organization in Israel, and extracted data concerning patients with FM. We matched two subjects without FM to each subject with FM by sex and age and geographic location. Baseline characteristics were evaluated by t-test for continuous variables and chi-square for categorical variables. Predictors of COVID-19 associated hospitalization were identified using univariable logistic regression model, significant variables were selected and analyzed by a multivariable logistic regression model. The initial cohort comprised 18,598 patients with FM and 36,985 matched controls. The mean age was 57.5± 14.5(SD), with a female dominance of 91%. Out of this cohort we extracted the study population, which included all patients contracted with COVID-19, and consisted of 571 patients with FM and 1008 controls. By multivariable analysis, the following variables were found to predict COVID-19 associated hospitalization in patients with FM: older age (OR, 1.25; CI, 1.13-1.39; p<0.001), male sex (OR, 2.63; CI, 1.18-5.88; p<0.05) and hypertension (OR, 1.75; CI, 1.04-2.95; p<0.05). The current population-based study revealed that FM per se was not directly associated with COVID-19 hospitalization or related mortality. Yet classical risk factors endangering the general population were also relevant among patients with FM.

Highlights

  • Fibromyalgia (FM) is characterized by widespread pain, unrefreshing sleep, fatigue, and cognitive impairment

  • The mean age was 57.5± 14.5(SD), with a female dominance of 91%. Out of this cohort we extracted the study population, which included all patients contracted with COVID-19, and consisted of 571 patients with FM and 1008 controls

  • The current population-based study revealed that FM per se was not directly associated with COVID-19 hospitalization or related mortality

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Summary

Introduction

Fibromyalgia (FM) is characterized by widespread pain, unrefreshing sleep, fatigue, and cognitive impairment. Sensitive bladder, irritable bowel disease and temporal-mandibular discomfort, are often encountered in these patients [1]. Accumulating evidence suggest that an imbalance between pro-inflammatory and anti-inflammatory cytokines may facilitate the emergence of neuropathic pain [7]. Elevated serum concentrations of IL-6, IL-8 and IL-1RA were detected in patients with FM [7,8,9]. These proinflammatory cytokines up regulate the expression of pain mediators such as substance P, which decrease pain threshold

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