Lyme Disease Tied to a Higher Risk of Fatigue

Pavankumar Kamat


April 04, 2022


  • The incidence rate of Lyme disease has increased over time in the UK.

  • Lyme disease was associated with a higher risk of any type of fatigue and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

  • Despite the association being weaker in the long term, it persisted beyond 6 months and varied by season.

Why This Matters

  • Findings support the NICE recommendations for the assessment and management of symptoms in patients who have been previously treated with Lyme disease, including chronic pain, depression and anxiety, fatigue, and sleep disturbance.

Study Design

  • The population-based historical cohort study used the IQVIA Medical Research Data (2000-2018).

  • 2130 patients with Lyme disease (Lyme cohort) were matched (1:4) with 8510 participants without Lyme disease (comparator cohort) who were followed up for a median duration of 3 years and 8 months.

  • Main outcomes: time to consultation for any fatigue-related symptoms or diagnosis and ME/CFS.

  • Funding: None.

Key Results

  • Over the study period, the incidence rate for Lyme disease was 5.18/100,000 person-years, increasing from 2.55 in 2000 to 9.33 in 2018.

  • The incidence rates of any type of fatigue were higher in the Lyme cohort vs comparator cohort (307.90 vs 165.60/10,000 person-years; HR 2.27; 95% CI 1.95 to 2.64).

  • A stronger association was seen between Lyme disease and any type of fatigue during the (adjusted HR [aHR]; 95% CI):

    • autumn season (3.14; 1.92 to 5.13); and

    • winter season (2.23; 1.21 to 4.11).

  • The incidence rates of ME/CFS were higher in the Lyme vs comparator cohort (11.76 vs 1.20/10,000 person-years; aHR 16.95; 95% CI 5.17 to 55.60).

  • The effects attenuated 6 months after the diagnosis of Lyme disease but were clearly noticeable.


  • Risk of residual confounding.

Brellier F, Pujades-Rodriguez M, Powell E, Mudie K, Mattos Lacerda E, Nacul L, Wing K. Incidence of Lyme disease in the United Kingdom and association with fatigue: A population-based, historical cohort study. PLoS One. 2022;17(3):e0265765. doi: 10.1371/journal.pone.0265765. PMID: 35320297 View Full Text.


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