Unger, Elizabeth R, Lin, Jin-Mann S, Wisk, Lauren E et al. · JAMA network open · 2024 · DOI
This study followed over 4,300 people for up to 12 months to see whether COVID-19 infection caused ME/CFS-like symptoms. Researchers found that about 3-4% of people reported ME/CFS-like symptoms after their acute illness, but this rate was similar whether they had tested positive or negative for COVID-19. The results suggest that while some people do develop long-lasting symptoms after illness, COVID-19 may not be uniquely causing ME/CFS more often than other infections.
Understanding whether SARS-CoV-2 specifically triggers ME/CFS is critical for affected patients seeking answers about disease causation and for public health planning regarding post-viral complications. This study provides important evidence that ME/CFS-like illness occurs at similar rates regardless of COVID-19 status, informing realistic expectations about long COVID and supporting research into broader post-viral mechanisms.
This study does not establish that COVID-19 cannot cause ME/CFS in individual cases, only that the population prevalence is not significantly elevated compared to non-infected controls. The reliance on self-reported symptoms without objective diagnostic markers or biomarifiers means true ME/CFS cases may have been misclassified. Declining follow-up rates over time may bias results if participants with worsening symptoms were more or less likely to remain engaged.
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
Unger, Elizabeth R, Lin, Jin-Mann S, Wisk, Lauren E, Yu, Huihui, L'Hommedieu, Michelle, Lavretsky, Helen, et al. (2024). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After SARS-CoV-2 Infection.. JAMA network open. https://doi.org/10.1001/jamanetworkopen.2024.23555
BibTeX
@article{mecfsatlas-unger-2024-myalgic-encephalomyelitis,
author = {Unger, Elizabeth R and Lin, Jin-Mann S and Wisk, Lauren E and Yu, Huihui and L'Hommedieu, Michelle and Lavretsky, Helen and Montoy, Juan Carlos C and Gottlieb, Michael A and Rising, Kristin L and Gentile, Nicole L and Santangelo, Michelle and Venkatesh, Arjun K and Rodriguez, Robert M and Hill, Mandy J and Geyer, Rachel E and Kean, Efrat R and Saydah, Sharon and McDonald, Samuel A and Huebinger, Ryan and Idris, Ahamed H and Dorney, Jocelyn and Hota, Bala and Spatz, Erica S and Stephens, Kari A and Weinstein, Robert A and Elmore, Joann G and Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group},
title = {Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After SARS-CoV-2 Infection.},
journal = {JAMA network open},
year = {2024},
doi = {10.1001/jamanetworkopen.2024.23555},
note = {PubMed: 39046739},
url = {https://www.mecfsatlas.com/evidence/unger-2024-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/unger-2024-myalgic-encephalomyelitis
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