Bonilla, Hector, Quach, Tom C, Tiwari, Anushri et al. · Frontiers in neurology · 2023 · DOI
This study looked at 140 people suffering from long COVID symptoms and found that nearly half of them (43%) met the medical criteria for ME/CFS. Most patients had severe fatigue, brain fog, and unrefreshing sleep that lasted around 9-10 months on average. People with higher body weight and greater functional decline were more likely to develop the ME/CFS form of long COVID.
This study provides critical epidemiological evidence that ME/CFS represents a substantial disease burden within the PASC population, with approximately 1 in 2.3 long COVID patients meeting formal diagnostic criteria. Understanding ME/CFS prevalence in post-COVID cohorts helps clinicians recognize this serious subtype and may guide patient stratification for future mechanistic and therapeutic research.
This study does not establish causation between COVID-19 infection and ME/CFS development, nor does it identify the biological mechanisms underlying either condition. The cross-sectional design cannot determine whether obesity and functional decline preceded or resulted from ME/CFS, and findings from a specialized clinic population may not generalize to all PASC patients.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Bonilla, Hector, Quach, Tom C, Tiwari, Anushri, Bonilla, Andres E, Miglis, Mitchell, Yang, Phillip C, et al. (2023). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic.. Frontiers in neurology. https://doi.org/10.3389/fneur.2023.1090747
BibTeX
@article{mecfsatlas-bonilla-2023-myalgic-encephalomyelitis,
author = {Bonilla, Hector and Quach, Tom C and Tiwari, Anushri and Bonilla, Andres E and Miglis, Mitchell and Yang, Phillip C and Eggert, Lauren E and Sharifi, Husham and Horomanski, Audra and Subramanian, Aruna and Smirnoff, Liza and Simpson, Norah and Halawi, Houssan and Sum-Ping, Oliver and Kalinowski, Agnieszka and Patel, Zara M and Shafer, Robert William and Geng, Linda N},
title = {Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic.},
journal = {Frontiers in neurology},
year = {2023},
doi = {10.3389/fneur.2023.1090747},
note = {PubMed: 36908615},
url = {https://www.mecfsatlas.com/evidence/bonilla-2023-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/bonilla-2023-myalgic-encephalomyelitis
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