ArticlemedRxiv : the preprint server for health sciences2025
Understanding Comorbidities in Hypermobile Ehlers-Danlos Syndrome: Could a Viral Infection Lead to a Diagnosis?
Megan L Pearson, Bryan J Laraway, Ellen R Elias, Ganna Bilousova, Melissa A Haendel, National Clinical Cohort Collaborative (N3C) Consortium
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In one paragraphArticle in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 · The registryThe trial behind it
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4 · The recordCorrections and comments
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5 · Who and what moneyAuthors and funding
6 authors.
Megan L PearsonDepartment of Dermatology; Gates Institute, University of Colorado Anschutz Medical Campus, Aurora CO, USA.ORCID 0000-0003-4830-7530 Bryan J LarawayDepartment of Genetics; University of North Carolina, Chapel Hill NC, USA.
Ellen R EliasDepartment of Pediatrics and Genetics, Children's Hospital Colorado, Aurora CO, USA.
Ganna BilousovaDepartment of Dermatology; Gates Institute, University of Colorado Anschutz Medical Campus, Aurora CO, USA.
Melissa A HaendelDepartment of Genetics; University of North Carolina, Chapel Hill NC, USA.
National Clinical Cohort Collaborative (N3C) Consortium
Funding
Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7MUniversity of Pittsburgh Clinical and Translational Science InstituteUL1TR001857 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2016 to 2025
$129.3MUCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1MClinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1MProject-005UL1TR001445 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BREDELLA, MIRIAM ANTOINETTE, HOCHMAN, JUDITH S · 2015 to 2025
$103.5MYale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9MPhenotypic Diversity in COVID-19UL1TR001878 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2016 to 2025
$102.4MTransform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0MClinical and Translational Science AwardUL1TR001873 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI REILLY, MUREDACH P · 2016 to 2025
$99.0MWU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8MThe Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0MImplementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1MGates Foundation INV-018455NCATS NIH HHS U24 TR002306NCATS NIH HHS UL1 TR001409NCATS NIH HHS UL1 TR001412NCATS NIH HHS UL1 TR001414NCATS NIH HHS UL1 TR001420NCATS NIH HHS UL1 TR001422NCATS NIH HHS UL1 TR001425NCATS NIH HHS UL1 TR001427NCATS NIH HHS UL1 TR001430NCATS NIH HHS UL1 TR001433NCATS NIH HHS UL1 TR001436NCATS NIH HHS UL1 TR001439NCATS NIH HHS UL1 TR001442NCATS NIH HHS UL1 TR001445NCATS NIH HHS UL1 TR001449NCATS NIH HHS UL1 TR001450NCATS NIH HHS UL1 TR001453NCATS NIH HHS UL1 TR001855NCATS NIH HHS UL1 TR001857NCATS NIH HHS UL1 TR001860NCATS NIH HHS UL1 TR001863NCATS NIH HHS UL1 TR001866NCATS NIH HHS UL1 TR001872NCATS NIH HHS UL1 TR001873NCATS NIH HHS UL1 TR001876NCATS NIH HHS UL1 TR001878NCATS NIH HHS UL1 TR001881NCATS NIH HHS UL1 TR001998NCATS NIH HHS UL1 TR002001NCATS NIH HHS UL1 TR002003NCATS NIH HHS UL1 TR002014NCATS NIH HHS UL1 TR002240NCATS NIH HHS UL1 TR002243NCATS NIH HHS UL1 TR002319NCATS NIH HHS UL1 TR002345NCATS NIH HHS UL1 TR002366NCATS NIH HHS UL1 TR002369NCATS NIH HHS UL1 TR002373NCATS NIH HHS UL1 TR002377NCATS NIH HHS UL1 TR002378NCATS NIH HHS UL1 TR002384NCATS NIH HHS UL1 TR002389NCATS NIH HHS UL1 TR002489NCATS NIH HHS UL1 TR002494NCATS NIH HHS UL1 TR002529NCATS NIH HHS UL1 TR002535NCATS NIH HHS UL1 TR002537NCATS NIH HHS UL1 TR002538NCATS NIH HHS UL1 TR002541NCATS NIH HHS UL1 TR002544NCATS NIH HHS UL1 TR002548NCATS NIH HHS UL1 TR002550NCATS NIH HHS UL1 TR002553NCATS NIH HHS UL1 TR002556NCATS NIH HHS UL1 TR002645NCATS NIH HHS UL1 TR002649NCATS NIH HHS UL1 TR002733NCATS NIH HHS UL1 TR002736NCATS NIH HHS UL1 TR003015NCATS NIH HHS UL1 TR003017NCATS NIH HHS UL1 TR003096NCATS NIH HHS UL1 TR003098NCATS NIH HHS UL1 TR003107NCATS NIH HHS UL1 TR003142NCATS NIH HHS UL1 TR003167NIAMS NIH HHS T32 AR007411NIGMS NIH HHS U54 GM104938NIGMS NIH HHS U54 GM104940NIGMS NIH HHS U54 GM104941NIGMS NIH HHS U54 GM104942NIGMS NIH HHS U54 GM115371NIGMS NIH HHS U54 GM115428NIGMS NIH HHS U54 GM115458NIGMS NIH HHS U54 GM115516NIGMS NIH HHS U54 GM115677NIGMS NIH HHS U54 GM133807
6 · The paper itselfAbstract
Hypermobile Ehlers-Danlos Syndrome (hEDS) is a complex, underdiagnosed connective tissue disorder characterized by widespread symptoms affecting multiple organ systems. Recent clinical observations suggest that individuals with hEDS may be at increased risk for persistent symptoms following COVID-19, commonly referred to as Long COVID. Using data from over 23 million patients across the United States, we examined associations between hEDS, COVID-19 infection, Long COVID, and related chronic conditions. We identified nearly 30,000 individuals with hEDS and found that the estimated prevalence was approximately 1 in 800, higher than previously recognized. While rates of COVID-19 infection were similar between patients with hEDS and matched controls, those with hEDS were significantly more likely to develop Long COVID. This risk was especially elevated among patients with hEDS with overlapping conditions commonly seen in post-viral syndromes, including autonomic dysfunction, immune dysregulation, and chronic fatigue. Specifically, individuals with postural orthostatic tachycardia, mast cell-related symptoms, or chronic fatigue syndrome had the highest rates of Long COVID. Cumulative incidence analysis revealed that many patients received an hEDS diagnosis only after a COVID-19 infection, suggesting that viral illness may exacerbate or reveal previously unrecognized symptoms. Patients with hEDS also exhibited higher odds of having additional risk factors for severe or prolonged illness, including chronic lung and autoimmune conditions, depression, and cerebrovascular disease. These findings highlight a previously unrecognized vulnerability in patients with hEDS and underscore the need for greater clinical awareness of their heightened risk for persistent post-COVID illness. Improved screening, earlier diagnosis, and integrated care pathways are urgently needed to support this complex and underserved patient population.
Identifiers
PMID41282714
PMCPMC12633589
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