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COVID Infection May Trigger Chronic Fatigue Syndrome

A major new study confirms that SARS-CoV-2 infection significantly increases the risk of developing new-onset chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), a complex and often disabling condition.

Researchers analyzed data from over 147,000 adults in the Montefiore Health System and found elevated risk for CFS/ME up to four years post-infection, regardless of whether the patient had been hospitalized for COVID-19.

Key findings include:

  • COVID-19 infection increased the risk of CFS/ME by 46%–56%.
  • Women were 54% more likely to develop CFS/ME than men.
  • People with existing autoimmune disease had a 57% higher risk of developing CFS/ME than those without.
  • Pre-existing anxiety also raised the risk of CFS/ME by 35%.
  • CFS/ME risk was not elevated by SARS-CoV-2 reinfection.
Table 2. Adjusted hazard ratios (HR) for developing chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) more than 30 days after COVID-19 infection.
Reproduced from Hadidchi et al., 2025.

While the exact mechanisms remain unclear, this study strengthens the link between viral infections and long-term autoimmune-like syndromes. The overlap between long COVID and CFS/ME, including fatigue, brain fog, and post-exertional malaise, underscores the urgent need for better recognition and care.

Citation

Hadidchi, R., Patel, B., Madan, J. et al. Elevated risk of new-onset chronic fatigue syndrome/myalgic encephalomyelitis up to four years after SARS-CoV-2 infection. J Transl Med 23, 815 (2025). https://doi.org/10.1186/s12967-025-06625-w