{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T10:30:55Z","timestamp":1784629855166,"version":"3.55.0"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To identify predicators of patients with fibromyalgia (FM) that are associated with a severe COVID-19 disease course.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We utilized the data base of the Clalit Health Services (CHS); the largest public organization in Israel, and extracted data concerning patients with FM. We matched two subjects without FM to each subject with FM by sex and age and geographic location. Baseline characteristics were evaluated by t-test for continuous variables and chi-square for categorical variables. Predictors of COVID-19 associated hospitalization were identified using univariable logistic regression model, significant variables were selected and analyzed by a multivariable logistic regression model.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The initial cohort comprised 18,598 patients with FM and 36,985 matched controls. The mean age was 57.5\u00b1 14.5(SD), with a female dominance of 91%. Out of this cohort we extracted the study population, which included all patients contracted with COVID-19, and consisted of 571 patients with FM and 1008 controls. By multivariable analysis, the following variables were found to predict COVID-19 associated hospitalization in patients with FM: older age (OR, 1.25; CI, 1.13\u20131.39; p&lt;0.001), male sex (OR, 2.63; CI, 1.18\u20135.88; p&lt;0.05) and hypertension (OR, 1.75; CI, 1.04\u20132.95; p&lt;0.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The current population-based study revealed that FM <jats:italic>per se<\/jats:italic> was not directly associated with COVID-19 hospitalization or related mortality. Yet classical risk factors endangering the general population were also relevant among patients with FM.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0261772","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T18:27:22Z","timestamp":1640888842000},"page":"e0261772","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["COVID-19 associated hospitalization in 571 patients with fibromyalgia\u2014A population-based study"],"prefix":"10.1371","volume":"16","author":[{"given":"Mor","family":"Amital","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niv","family":"Ben-Shabat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-7716","authenticated-orcid":true,"given":"Howard","family":"Amital","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Buskila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnon D.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Amital","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,30]]},"reference":[{"issue":"3","key":"pone.0261772.ref001","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jbspin.2007.09.010","article-title":"Pathogenesis of fibromyalgia\u2013a review","volume":"75","author":"J Ablin","year":"2008","journal-title":"Joint Bone Spine"},{"issue":"15","key":"pone.0261772.ref002","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1001\/jama.2014.3266","article-title":"Fibromyalgia: A Clinical Review","volume":"311","author":"DJ Clauw","year":"2014","journal-title":"JAMA"},{"issue":"10","key":"pone.0261772.ref003","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1002\/art.1780301007","article-title":"The \u201cchronic, active epstein-barr virus infection\u201d syndrome and primary fibromyalgia","volume":"30","author":"D Buchwald","year":"1987","journal-title":"Arthritis Rheum Off J Am Coll Rheumatol"},{"issue":"3","key":"pone.0261772.ref004","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jaut.2006.09.004","article-title":"Fibromyalgia, infection and vaccination: two more parts in the etiological puzzle","volume":"27","author":"JN Ablin","year":"2006","journal-title":"J Autoimmun"},{"issue":"21","key":"pone.0261772.ref005","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1001\/archinte.1997.00440420129014","article-title":"Fibromyalgia in hepatitis C virus infection: another infectious disease relationship","volume":"157","author":"D Buskila","year":"1997","journal-title":"Arch Intern Med"},{"issue":"3","key":"pone.0261772.ref006","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/01.rhu.0000165291.91623.5c","article-title":"Fibromyalgia frequency in hepatitis B carriers","volume":"11","author":"B Adak","year":"2005","journal-title":"JCR J Clin Rheumatol"},{"issue":"2","key":"pone.0261772.ref007","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.imlet.2014.01.009","article-title":"Fibromyalgia and cytokines","volume":"161","author":"I Rodriguez-Pint\u00f3","year":"2014","journal-title":"Immunol Lett"},{"issue":"1","key":"pone.0261772.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2474-12-245","article-title":"Systematic review with meta-analysis: cytokines in fibromyalgia syndrome","volume":"12","author":"N \u00dc\u00e7eyler","year":"2011","journal-title":"BMC Musculoskelet Disord"},{"issue":"7","key":"pone.0261772.ref009","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1093\/rheumatology\/40.7.743","article-title":"Cytokines play an aetiopathogenetic role in fibromyalgia: a hypothesis and pilot study","volume":"40","author":"DJ Wallace","year":"2001","journal-title":"Rheumatology"},{"key":"pone.0261772.ref010","article-title":"How NETosis could drive \u201cPost-COVID-19 syndrome\u201d among survivors","author":"SA Sawadogo","year":"2020","journal-title":"Immunol Lett"},{"key":"pone.0261772.ref011","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.bbi.2020.07.037","article-title":"Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors","volume":"89","author":"MG Mazza","year":"2020","journal-title":"Brain Behav Immun"},{"key":"pone.0261772.ref012","first-page":"47","volume-title":"In: Seminars in Arthritis and Rheumatism","author":"D Buskila","year":"2000"},{"key":"pone.0261772.ref013","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3389\/fpubh.2020.00152","article-title":"Gender differences in patients with COVID-19: focus on severity and mortality","volume":"8","author":"J-M Jin","year":"2020","journal-title":"Front Public Health"},{"issue":"1","key":"pone.0261772.ref014","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/BOR.0000000000000464","article-title":"The complexities of fibromyalgia and its comorbidities","volume":"30","author":"A Lichtenstein","year":"2018","journal-title":"Curr Opin Rheumatol"},{"issue":"6","key":"pone.0261772.ref015","first-page":"S73","article-title":"Lifetime post-traumatic stress symptoms are related to the health-related quality of life and severity of pain\/fatigue in patients with fibromyalgia","volume":"29","author":"L Dell\u2019Osso","year":"2011","journal-title":"Clin Exp Rheumatol-Incl Suppl"},{"issue":"3","key":"pone.0261772.ref016","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1002\/art.20042","article-title":"Family study of fibromyalgia","volume":"50","author":"LM Arnold","year":"2004","journal-title":"Arthritis Rheum"},{"issue":"3","key":"pone.0261772.ref017","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.comppsych.2008.08.004","article-title":"What is the effect of selective serotonin reuptake inhibitors on temperament and character in patients with fibromyalgia?","volume":"50","author":"M Mazza","year":"2009","journal-title":"Compr Psychiatry"},{"issue":"1","key":"pone.0261772.ref018","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3109\/03009742.2015.1052553","article-title":"Association of rheumatic diseases with symptom severity, quality of life, and treatment outcome in patients with fibromyalgia","volume":"45","author":"J Jiao","year":"2016","journal-title":"Scand J Rheumatol"},{"key":"pone.0261772.ref019","first-page":"129","volume-title":"Seminars in arthritis and rheumatism","author":"A Fan","year":"2017"},{"issue":"2 Suppl","key":"pone.0261772.ref020","first-page":"S40","article-title":"Fibromyalgia prevalence and related factors in a large registry of patients with systemic lupus erythematosus","volume":"34","author":"V Torrente-Segarra","year":"2016","journal-title":"Clin Exp Rheumatol"},{"issue":"4","key":"pone.0261772.ref021","first-page":"695","article-title":"Severe rheumatoid arthritis (RA), worse outcomes, comorbid illness, and sociodemographic disadvantage characterize ra patients with fibromyalgia","volume":"31","author":"F Wolfe","year":"2004","journal-title":"J Rheumatol"},{"issue":"1","key":"pone.0261772.ref022","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2474-7-4","article-title":"Major depression, fibromyalgia and labour force participation: a population-based cross-sectional study","volume":"7","author":"A Kassam","year":"2006","journal-title":"BMC Musculoskelet Disord"},{"issue":"5","key":"pone.0261772.ref023","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.reuma.2017.02.008","article-title":"Clinical significance of fibromyalgia syndrome in different rheumatic diseases: relation to disease activity and quality of life","volume":"14","author":"NK Mahmoud","year":"2018","journal-title":"Reumatol Cl\u00ednica Engl Ed"},{"key":"pone.0261772.ref024","first-page":"2","volume":"1","author":"HO Mirghani","year":"2016","journal-title":"Are diabetes mellitus, restless syndrome, and fibromyalgia related? prevalence"},{"issue":"9","key":"pone.0261772.ref025","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1007\/s00296-017-3725-2","article-title":"Prevalence of fibromyalgia in general population and patients, a systematic review and meta-analysis","volume":"37","author":"F Heidari","year":"2017","journal-title":"Rheumatol Int"},{"issue":"8","key":"pone.0261772.ref026","article-title":"Increased risk of stroke in patients with fibromyalgia: a population-based cohort study","volume":"95","author":"C-H Tseng","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"pone.0261772.ref027","first-page":"368","article-title":"Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study","author":"T Chen","year":"2020","journal-title":"bmj"},{"key":"pone.0261772.ref028","volume-title":"British Medical Journal","author":"RE Jordan","year":"2020"},{"key":"pone.0261772.ref029","first-page":"10","article-title":"Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis","author":"J Yang","year":"2020","journal-title":"Int J Infect Dis"},{"issue":"6","key":"pone.0261772.ref030","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1002\/oby.22818","article-title":"Obesity and its implications for COVID-19 mortality","volume":"28","author":"W Dietz","year":"2020","journal-title":"Obesity"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T18:27:45Z","timestamp":1640888865000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261772"}},"subtitle":[],"editor":[{"given":"Ying-Mei","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,12,30]]},"references-count":30,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0261772","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,30]]}}}