Chen, Chih-Wei, Lee, Hsun-Hua, Chang, Shu-Hao et al. · Journal of infection and public health · 2024 · DOI
This study looked at over 6 million patient records to compare people who had COVID-19 with people who didn't. Researchers found that people who had COVID-19 were about 1.6 times more likely to develop chronic fatigue syndrome (CFS) afterward. The increased risk appeared in people of all ages, both sexes, and different racial backgrounds.
This study provides robust, large-scale evidence that COVID-19 is associated with elevated CFS risk across diverse patient populations, which can help clinicians identify high-risk patients and guide clinical management. Understanding this association is crucial for recognizing post-COVID CFS as a significant public health concern and informing prevention and early intervention strategies.
This observational study demonstrates association but not causation—other unmeasured factors could contribute to the increased CFS diagnosis in COVID-19 survivors. The study relies on diagnostic codes in medical records rather than standardized ME/CFS diagnostic criteria, so it cannot confirm that all identified cases meet rigorous case definitions. Additionally, the study cannot explain the biological mechanisms by which COVID-19 increases CFS risk.
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
Chen, Chih-Wei, Lee, Hsun-Hua, Chang, Shu-Hao, Chen, Yi-Ling, Wang, Yu-Hsun, Leong, Pui-Ying, et al. (2024). Risk of chronic fatigue syndrome after COVID-19: A retrospective cohort study of 3227281 patients.. Journal of infection and public health. https://doi.org/10.1016/j.jiph.2024.102559
BibTeX
@article{mecfsatlas-chen-2024-risk-chronic,
author = {Chen, Chih-Wei and Lee, Hsun-Hua and Chang, Shu-Hao and Chen, Yi-Ling and Wang, Yu-Hsun and Leong, Pui-Ying and Wei, James Cheng-Chung},
title = {Risk of chronic fatigue syndrome after COVID-19: A retrospective cohort study of 3227281 patients.},
journal = {Journal of infection and public health},
year = {2024},
doi = {10.1016/j.jiph.2024.102559},
note = {PubMed: 39418958},
url = {https://www.mecfsatlas.com/evidence/chen-2024-risk-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/chen-2024-risk-chronic
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