Post-Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current Knowledge and Future Directions

Figures & data

Table 1. Summary of viral agents associated with post-viral syndrome.

Virus	Discriminatory signs and symptoms	Diagnostic tools	Treatment for post-viral symptoms
COVID-19	Acute stage: Fever, cough, dyspnea, fatigue, myalgia Post-viral stage: Myalgia, arthralgia, chronic fatigue, neuropathic pain, sleep disorder, depression, anxiety, PTSD	RT-PCR	Aerobic activity CBT BBTI APAP Antidepressants Gabapentinoids Systemic corticosteroids IVIG
CHIKV	Acute stage: Fever, rash, arthralgia Post-viral stage: Arthralgia, myelitis	RT-PCR	Physiotherapy NSAIDs Systemic corticosteroids DMARDs (e.g., methotrexate)
VZV	Acute stage: Pruritic fluid-filled vesicles Post-viral stage: Dermatomal rash, postherpetic neuralgia	PCR	Mindfulness CBT Antivirals Gabapentinoids TCAs Serotonin–norepinephrine reuptake inhibitors Opioids Cannabinoids
Poliovirus	Acute stage: Fatigue, headache, neck stiffness Post-viral stage: Myalgia, arthralgia, neuropathic pain, functional decline, fatigue	RT-PCR	IVIG
HIV	Acute stage: Myalgia, arthralgia, weight loss, cervical lymphadenopathy Post-viral stage: Allodynia, anxiety, depression, PTSD	RT-PCR Nucleic acid–based amplification assay	CBT

RT-PCT = reverse transcription polymerase chain reaction; DMARD = disease-modifying antirheumatic drug; PCR = polymerase chain reaction.

Figure 1. Simplified pathophysiology of post-viral syndromes.