Prolonged COVIDs are sometimes chronic fatigue syndromes (myalgic encephalomyelitis)

Other people have similar but less severe symptoms that do not meet the criteria for the syndrome. Differences in laboratory findings between these two groups may indicate differences in underlying mechanisms.

“Suspicions that COVID-19 could trigger ME/CFS arose from the first wave of the pandemicsays Carmen Scheibenbogen of the Charity – Universitätsmedizin Berlin. “Through an extensive diagnostic process and extensive comparison with patients who developed ME/CFS as a result of infections unrelated to COVID-19, we were able to show that COVID-19 can trigger ME/CFS“, she explains.

Scheibenbogen and colleagues looked at 42 people who presented to a medical center with severe and persistent fatigue and impaired daily functioning six months after SARS-CoV-2 infection. Most of them could not do light work for more than two to four hours a day; some were unable to work and had difficulty taking care of themselves. Having been infected during the first wave of the pandemic, none of them had been vaccinated.

Only three of them required hospital care during their initial SARS-CoV-2 infection, but none required oxygen. Thirty-two met the WHO classification of mild COVID-19, meaning they did not develop pneumonia but had fairly severe symptoms, including fever, cough, muscle and joint aches for one to two weeks.

The participants were examined by an interdisciplinary team of neurologists, immunologists, rheumatologists, cardiologists, endocrinologists, and pulmonologists with extensive experience in the diagnosis of ME/CFS. The diagnosis was made using the “Canadian Consensus Criteria” (1).

For comparison, 19 matched people who had developed ME/CFS after a similar period of illness due to a non-COVID infection were also examined.

About half of the participants tested after contracting COVID met these criteria. The other half had similar symptoms, but their post-exercise discomfort was milder and only lasted a few hours. While participants with ME/CFS reported post-exercise discomfort that persisted overnight. (Symptoms of post-exercise malaise that characterize chronic fatigue syndrome)

“Therefore, we can distinguish two groups of post-COVID patients whose physical functioning is severely affected.concludes Judith Bellman-Strobl, co-author.

Participants’ symptoms were then related to hand grip strength, which was reduced in most of them. “In addition, we found that people with milder exercise intolerance had reduced grip strength if they had elevated levels of the cytokine interleukin 8. In these cases, the reduced muscle strength may be due to a persistent inflammatory response.Scheibenbogen explains.

“However, in the ME/CFS group, handgrip strength was correlated with the hormone NT-proBNP, which can be released by muscle cells when oxygen supply is insufficient. This suggests that in these people, muscle weakness may be due to insufficient blood supply.»

Based on preliminary observations, the two groups might also differ in terms of disease progression. “In many people whose symptoms are indicative of ME/CFS but who do not meet diagnostic criteria, symptoms appear to improve over time.Scheibenbogen explains.

These new findings could help researchers develop specific treatments for post-COVID syndrome (“long covid”) and for ME/CFS.

“Our data also provide additional evidence that ME/CFS is not a psychosomatic disorder but rather a serious physical illness that can be measured and diagnosed using objective methods.Scheibenbogen says. (Chronic Fatigue Syndrome symptoms are too often considered psychosomatic in emergency situations)

“Unfortunately, current treatments for ME/CFS are purely symptomatic in nature. That is why I even invite young people to protect themselves against SARS-CoV-2 by getting vaccinated and wearing an FFP2 mask.“, he concludes. (Chronic Fatigue Syndrome: Staying in Your “Energy Bubble”)

For more information on chronic fatigue syndrome (myalgic encephalomyelitis), see the links below.

(1) These criteria can be consulted on page 141 of the document Chronic Fatigue Syndrome: State of Knowledge and Evaluation of Intervention Methods in Québec published in 2010 by AETMIS (replaced byNational Institute of Excellence in Health and Social Services [Inesss] in 2011).

psychomedia with sources: Charité – Universitätsmedizin Berlin, Nature Communications.
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