Tusconi, Massimo, Dursun, Serdar M, Pegreffi, Francesco et al. · Frontiers in psychiatry · 2025 · DOI
This study found that people with long COVID who developed ME/CFS-like symptoms were much more likely to have had hypothyroidism (an underactive thyroid) or bipolar spectrum disorders before getting sick compared to people from before the pandemic. The researchers suggest these pre-existing conditions might make someone more vulnerable to developing ME/CFS after COVID-19, possibly because they affect sleep rhythms and immune function.
Identifying potential risk factors for ME/CFS development in long COVID could enable earlier recognition and intervention for vulnerable populations. Understanding whether thyroid function and mood regulation disorders contribute to ME/CFS susceptibility may inform preventive strategies and personalized treatment approaches for at-risk long COVID patients.
This study cannot prove that hypothyroidism or bipolar spectrum disorders cause ME/CFS—only that they are more common in people who developed it. The retrospective design and reliance on clinical trial participants (rather than population-based sampling) may not represent all long COVID patients. The significantly smaller case group (n=36) compared to historical controls limits generalizability.
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
Tusconi, Massimo, Dursun, Serdar M, Pegreffi, Francesco, Aviles Gonzalez, Cesar Ivan, Barrui, Vanessa, Fornaro, Michele, et al. (2025). Bipolar spectrum, hypothyroidism, and their association with chronic fatigue/myalgic encephalomyelitis-like syndrome in long COVID: could they be identified as early determinants?. Frontiers in psychiatry. https://doi.org/10.3389/fpsyt.2025.1623288
BibTeX
@article{mecfsatlas-tusconi-2025-bipolar-spectrum,
author = {Tusconi, Massimo and Dursun, Serdar M and Pegreffi, Francesco and Aviles Gonzalez, Cesar Ivan and Barrui, Vanessa and Fornaro, Michele and Hurtado Lujan, Luz Alba and Camacho Nunez, Lina Patricia and Vega Ochoa, Arley Denisse and Curcio, Felice and Carta, Mauro Giovanni and Cossu, Giulia},
title = {Bipolar spectrum, hypothyroidism, and their association with chronic fatigue/myalgic encephalomyelitis-like syndrome in long COVID: could they be identified as early determinants?},
journal = {Frontiers in psychiatry},
year = {2025},
doi = {10.3389/fpsyt.2025.1623288},
note = {PubMed: 40950756},
url = {https://www.mecfsatlas.com/evidence/tusconi-2025-bipolar-spectrum},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/tusconi-2025-bipolar-spectrum
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