2024 — Long COVID + hypermobility shared pathophysiology
One-paragraph summary
Review documenting that hypermobility has been detected in 30-57% of patients with ME/CFS, fibromyalgia, POTS, and long COVID vs. the general population. Reviews extra-musculoskeletal symptoms across HSD / hEDS (the conditions accounting for >90% of joint hypermobility cases). Frames shared pathophysiology between long COVID and hypermobility-spectrum disorders. For the project, this paper directly anchors the B26 bridge (EDS / hypermobility ↔ FM via shared dysautonomia + SFN + ANA) with a substantial prevalence figure across the project's core cross-condition cluster (ME/CFS, FM, POTS, long COVID). The 30-57% hypermobility prevalence in these conditions is substantial enough that hypermobility/EDS-overlap stratification becomes a candidate biomarker-mapping cohort dimension.
Claims as triples
hypermobility_spectrum — present_in → fm_central_only[evidence: 30-57% hypermobility prevalence in FM cohorts; confidence: emerging]hypermobility_spectrum — present_in → me_cfs[evidence: same prevalence range cited; confidence: emerging]hypermobility_spectrum — present_in → post_covid_syndrome[evidence: same prevalence range cited; confidence: emerging]hypermobility_spectrum — bridges → autonomic_dysregulation[evidence: shared POTS + dysautonomia framework; confidence: emerging]
Triangulation notes
- Anchor citation for B26 bridge (EDS / hypermobility ↔ FM via shared dysautonomia + SFN + ANA, added 2026-05-10 from over-regulation audit Recommendation 1).
- Adds Beighton-score / hypermobility-screening as a candidate biomarker-mapping cohort dimension — cheap clinical screening (5-minute exam) that could stratify the 30-57% hypermobility-positive subset.
- Discovered via B26 bridge query.
Open questions raised
- Does the hypermobility-positive FM subset overlap substantially with the HαT/TPSAB1-positive subset (Lyons 2019)?
- Are hypermobility-positive FM patients differentially responsive to MCAS-stratified cromolyn vs. other cure-path arms?