Postviral fatigue syndrome, neurasthenia and fibromyalgia

Metadata

Name	Postviral fatigue syndrome, neurasthenia and fibromyalgia (chronic_fatigue)
Category	Neurological
Sex
Adult	Yes
UUID	e8ae7b9d-2d64-42c3-bbaf-4be2164fb946
Definition	Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that lasts for at least six months and that can’t be fully explained by an underlying medical condition.

Ontologies

Disease Ontology (DOID)	DOID_8544
GWAS Catalogue	EFO_0004540
MeSH	D015673
SNOMED-CT	51771007
FinnGen	G6_POSTVIRFAT

Key Summary Statistics

Cases from any source

Total	10456
Female (%)	8184 (78%)
Male (%)	2272 (22%)

Year first recorded

Cases linked in all UK Biobank sources

Cross-source concordance

Vertical bars correspond to number of cases per source/intersection; horizontal bars to left correspond to total number of cases per source.

Incidence & prevalence

Baseline prevalence stratified by sex

Female	261.92 (251.18,272.67)
Male	110.87 (103.2,118.55)

Incidence stratified by sex

Female	12.22 (11.3,13.15)
Male	3.51 (2.98,4.05)

Incidence stratified by age

Ages 40-44	9.94 (7.97,11.92)
Ages 45-49	12.51 (10.6,14.42)
Ages 50-54	10.91 (9.26,12.56)
Ages 55-59	8.48 (7.16,9.79)
Ages 60-64	6.16 (5.2,7.12)
Ages 65-69	4.8 (3.83,5.77)

Period prevalence

Methods

Comparison with general population

Sex-standardised prevalence from CALIBER study (Kuan et al. 2019)

Population	Ages 40-49	Ages 50-59	Ages 60-69
UK Biobank	250 (235,265)	264 (252,276)	231 (221,241)
CALIBER	209 (206,213)	263 (258,268)	238 (233,243)

Stratified by age and Townsend deprivation status

Deprivation status	Ages 40-49	Ages 50-59	Ages 60-69
Least deprived	218(186,255)	221(197,247)	227(207,249)
Low	240(206,278)	251(226,279)	213(194,235)
Medium	230(198,265)	249(224,277)	243(222,266)
High	275(243,311)	293(265,322)	219(198,242)
Most deprived	273(243,307)	304(276,335)	254(230,280)

Stratified by age and country

Country	Ages 40-49	Ages 50-59	Ages 60-69
England	229(213,245)	242(229,255)	212(201,222)
Scotland	213(175,256)	256(225,291)	234(207,264)
Wales	549(470,638)	496(438,559)	428(381,479)

Risk factors analysis

‘Healthy’ BMI, smoking status ‘never’, or no hypertension (absence of hypertension records) were considered as reference values.

Hazard Ratio (HR) values with P < 0.0002 were considered to show significant association with disease onset after correction for multiple-testing using the Bonferroni method

N=153420, Events=132

Factor	Level	Hazard Ratio	P value
BMI	overweight	0.98 (0.66, 1.47)	0.928
BMI	obese	1.08 (0.69, 1.7)	0.735
BMI	underweight	0 (0, Inf)	0.992
smoking	previous	1.16 (0.78, 1.73)	0.462
smoking	current	2.27 (1.45, 3.57)	0.000355
hypertension	yes	1.19 (0.76, 1.85)	0.449

Definition

UK Biobank field id	Description	Code	Value
20002	Non-cancer illness code, self-reported	1542	fibromyalgia
20002	Non-cancer illness code, self-reported	1482	chronic fatigue syndrome
41202	Diagnoses - main ICD10	G93.3	Postviral fatigue syndrome
41202	Diagnoses - main ICD10	F48.0	Neurasthenia
41202	Diagnoses - main ICD10	M79.7	Fibromyalgia
41204	Diagnoses - secondary ICD10	G93.3	Postviral fatigue syndrome
41204	Diagnoses - secondary ICD10	F48.0	Neurasthenia
41204	Diagnoses - secondary ICD10	M79.7	Fibromyalgia
40001	Underlying (primary) cause of death: ICD10	G93.3	Postviral fatigue syndrome
40001	Underlying (primary) cause of death: ICD10	F48.0	Neurasthenia
40001	Underlying (primary) cause of death: ICD10	M79.7	Fibromyalgia
40002	Contributory (secondary) causes of death: ICD10	G93.3	Postviral fatigue syndrome
40002	Contributory (secondary) causes of death: ICD10	F48.0	Neurasthenia
40002	Contributory (secondary) causes of death: ICD10	M79.7	Fibromyalgia
42040	GP clinical event records	8HlL.00	Referral for chronic fatigue syndrome activity management
42040	GP clinical event records	8HlL.11	Referral for myalgic encephalopathy activity management
42040	GP clinical event records	8Q1..00	Activity management for chronic fatigue syndrome
42040	GP clinical event records	8Q1..11	Activity management for myalgic encephalopathy
42040	GP clinical event records	E205.00	Neurasthenia - nervous debility
42040	GP clinical event records	Eu46000	[X]Neurasthenia
42040	GP clinical event records	Eu46011	[X]Fatigue syndrome
42040	GP clinical event records	F03y.12	Myalgic encephalomyelitis
42040	GP clinical event records	F286000	Mild chronic fatigue syndrome
42040	GP clinical event records	F286100	Moderate chronic fatigue syndrome
42040	GP clinical event records	F286200	Severe chronic fatigue syndrome
42040	GP clinical event records	F286.00	Chronic fatigue syndrome
42040	GP clinical event records	F286.11	CFS - Chronic fatigue syndrome
42040	GP clinical event records	F286.12	Postviral fatigue syndrome
42040	GP clinical event records	F286.13	PVFS - Postviral fatigue syn
42040	GP clinical event records	F286.14	Post-viral fatigue syndrome
42040	GP clinical event records	F286.15	Myalgic encephalomyelitis
42040	GP clinical event records	F286.16	ME - Myalgic encephalomyelitis
42040	GP clinical event records	N239.00	Fibromyalgia
42040	GP clinical event records	N240100	Fibrositis unspecified
42040	GP clinical event records	N240500	Fibrositis of neck
42040	GP clinical event records	N240600	Fibrositis arm
42040	GP clinical event records	N248.00	Fibromyalgia
42040	GP clinical event records	R007400	[D]Postviral (asthenic) syndrome
42040	GP clinical event records	R007411	[D]Post viral debility
42040	GP clinical event records	XaRAz	Referral for chronic fatigue syndrome activity management
42040	GP clinical event records	XaPom	Mild chronic fatigue syndrome
42040	GP clinical event records	XE15C	Other causes of encephalitis
42040	GP clinical event records	XaPeC	Activity management for chronic fatigue syndrome
42040	GP clinical event records	Xa01F	Chronic fatigue syndrome
42040	GP clinical event records	X75rx	Fibromyalgia
42040	GP clinical event records	X75rx	Fibromyalgia
42040	GP clinical event records	XaPon	Moderate chronic fatigue syndrome
42040	GP clinical event records	XaPoo	Severe chronic fatigue syndrome
120010	Ever had chronic Fatigue Syndrome or Myalgic Encephalomyelitis (M.E.)	1	yes
120009	Ever had fibromyalgia	1	yes