A systematic scoping review of new-onset fibromyalgia manifestations after non-hospitalized Covid-19: empirics, methodologies, definitions, pathophysiology, prevalences, and knowledge gaps
1
General practice, Meuhedet Health Services, Jerusalem, Israel
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
OBJECTIVE:
To systematically review empirical evidence on new-onset fibromyalgia after COVID-19 in non-hospitalized cases. The purpose is to summarize epidemiological studies, estimate prevalence rates, map the literature, clarify key concepts, review the methodologies being used, summarize the putative theories, and identify anomalies and gaps in current knowledge.
METHODS:
a systematic search on Medline, Web of Science, and PsycINFO using terms related to fibromyalgia, central sensitization, and COVID-19, screening all studies from inception until 2025. Included were studies on de novo fibromyalgia after non-severe non-hospitalized COVID-19, abstracting key data and following PRISMA-ScR recommendations.
RESULTS:
228 records were included in total. Various types of methods, tools, and study designs are being used for Long COVID-19 (LC) research, with inconsistency in key concepts and definitions. This leads to a fragmented understanding of the relationship between SARS-CoV-2 infection and LC. Common themes include: chronic fatigue post-viral infection, chronic pain after COVID-19, putative LC mechanisms, central sensitization, and interventions. Post-COVID-19 fibromyalgia prevalence studies, primarily surveys and database analyses, are ongoing and susceptible to bias. The empirical evidence supports an overlap between LC, chronic fatigue syndrome, and fibromyalgia but the molecular mechanisms still remain unclear. Mechanisms such as neuroinflammation, immune dysregulation, viral persistence, glial cell reactivity, and central pain augmentation are studied, yet are under-researched, and with conflicting findings regarding presence of viral particles, condition pain modulation, central sensitization, autoantibodies and more.
CONCLUSIONS:
Post-COVID-19 fibromyalgia presents a significant challenge to primary and community care medicine, requiring a collaborative interdisciplinary approach, integrating evolving knowledge. This review highlights the need for standardized definitions and rigorous methodologies in research on the phenomenon of post-COVID-19 fibromyalgia. Future research should focus on epidemiological population-based studies with representative sampling and improving methodology, refining evolving definitions, elucidating neurological mechanisms in hypothesis driven studies, and developing effective therapeutic strategies.
To systematically review empirical evidence on new-onset fibromyalgia after COVID-19 in non-hospitalized cases. The purpose is to summarize epidemiological studies, estimate prevalence rates, map the literature, clarify key concepts, review the methodologies being used, summarize the putative theories, and identify anomalies and gaps in current knowledge.
METHODS:
a systematic search on Medline, Web of Science, and PsycINFO using terms related to fibromyalgia, central sensitization, and COVID-19, screening all studies from inception until 2025. Included were studies on de novo fibromyalgia after non-severe non-hospitalized COVID-19, abstracting key data and following PRISMA-ScR recommendations.
RESULTS:
228 records were included in total. Various types of methods, tools, and study designs are being used for Long COVID-19 (LC) research, with inconsistency in key concepts and definitions. This leads to a fragmented understanding of the relationship between SARS-CoV-2 infection and LC. Common themes include: chronic fatigue post-viral infection, chronic pain after COVID-19, putative LC mechanisms, central sensitization, and interventions. Post-COVID-19 fibromyalgia prevalence studies, primarily surveys and database analyses, are ongoing and susceptible to bias. The empirical evidence supports an overlap between LC, chronic fatigue syndrome, and fibromyalgia but the molecular mechanisms still remain unclear. Mechanisms such as neuroinflammation, immune dysregulation, viral persistence, glial cell reactivity, and central pain augmentation are studied, yet are under-researched, and with conflicting findings regarding presence of viral particles, condition pain modulation, central sensitization, autoantibodies and more.
CONCLUSIONS:
Post-COVID-19 fibromyalgia presents a significant challenge to primary and community care medicine, requiring a collaborative interdisciplinary approach, integrating evolving knowledge. This review highlights the need for standardized definitions and rigorous methodologies in research on the phenomenon of post-COVID-19 fibromyalgia. Future research should focus on epidemiological population-based studies with representative sampling and improving methodology, refining evolving definitions, elucidating neurological mechanisms in hypothesis driven studies, and developing effective therapeutic strategies.
| eISSN: | 2654-1459 |
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