Spatz, Erica S, Gottlieb, Michael, Wisk, Lauren E et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023 · DOI
This study followed adults who tested positive or negative for COVID-19 and tracked their symptoms over three months. At the three-month mark, people who had COVID-19 were much more likely to still have symptoms like fatigue, breathing problems, or muscle pain compared to those who tested negative. Importantly, symptoms of post-infectious syndromes (like unrefreshing sleep and fatigue) were common in both groups, suggesting these symptoms can occur even without COVID-19 infection.
This study is important because it tracks the natural progression of post-COVID symptoms and compares them to similar symptoms in non-infected individuals, helping researchers understand whether long-COVID and ME/CFS share common mechanisms. For ME/CFS patients, this work highlights that post-infectious fatigue and related symptoms are measurable, trackable outcomes worthy of clinical attention and future investigation.
This study does not prove that COVID-19 causes ME/CFS or that all long-COVID cases develop into ME/CFS. It also does not establish causation for post-infectious syndrome symptoms, since these symptoms appeared equally in COVID-negative participants, suggesting multiple possible etiologies. The three-month timeframe is relatively short for understanding chronic sequelae.
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
Spatz, Erica S, Gottlieb, Michael, Wisk, Lauren E, Anderson, Jill, Chang, Anna Marie, Gentile, Nicole L, et al. (2023). Three-Month Symptom Profiles Among Symptomatic Adults With Positive and Negative Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Prospective Cohort Study From the INSPIRE Group.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. https://doi.org/10.1093/cid/ciac966
BibTeX
@article{mecfsatlas-spatz-2023-three-month,
author = {Spatz, Erica S and Gottlieb, Michael and Wisk, Lauren E and Anderson, Jill and Chang, Anna Marie and Gentile, Nicole L and Hill, Mandy J and Huebinger, Ryan M and Idris, Ahamed H and Kinsman, Jeremiah and Koo, Katherine and Li, Shu-Xia and McDonald, Samuel and Plumb, Ian D and Rodriguez, Robert M and Saydah, Sharon and Slovis, Benjamin and Stephens, Kari A and Unger, Elizabeth R and Wang, Ralph C and Yu, Huihui and Hota, Bala and Elmore, Joann G and Weinstein, Robert A and Venkatesh, Arjun},
title = {Three-Month Symptom Profiles Among Symptomatic Adults With Positive and Negative Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Prospective Cohort Study From the INSPIRE Group.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {2023},
doi = {10.1093/cid/ciac966},
note = {PubMed: 36573005},
url = {https://www.mecfsatlas.com/evidence/spatz-2023-three-month},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/spatz-2023-three-month
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