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Long COVIDs are sometimes chronic fatigue syndromes (myalgic encephalomyelitis)


A German study, published in August 2022 in NatureCommunicationsshows that indeed, even after mild COVID-19, some people develop symptoms that meet the diagnostic criteria for ME/CFS.

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 emerged from the first wave of the pandemicsays Carmen Scheibenbogen of the Charity – Universitätsmedizin Berlin. “Through a thorough diagnostic process and extensive comparison with patients who developed ME/CFS as a result of non-COVID related infections, 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 persistent and severe fatigue and impaired daily functioning six months after their SARS-CoV-2 infection. Most of them were unable to 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 needed hospital care during their initial SARS-CoV-2 infection, but none needed 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, aches and pains. muscles and joints for one to two weeks.

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

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

About half of the participants screened 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 characterizes chronic fatigue syndrome)

We can therefore distinguish two groups of post-COVID patients whose physical functioning is severely impairedconcludes Judith Bellman-Strobl, co-author.

The participants’ symptoms were then related to their hand grip strength, which was reduced in the majority of them. “We further 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 reduction in muscle strength may be caused by a persistent inflammatory responseexplains Scheibenbogen.

In the ME/CFS group, however, hand grip 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 caused by insufficient blood supply.»

According to preliminary observations, the two groups could also differ in terms of disease progression. “In many people whose symptoms are indicative of ME/CFS but who do not meet the diagnostic criteria, the symptoms seem to improve over timeexplains Scheibenbogen.

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

Our data also provide further evidence that ME/CFS is not a psychosomatic disorder but a serious physical illness that can be measured and diagnosed using objective methods.says Scheibenbogen. (The symptoms of chronic fatigue syndrome too often considered psychosomatic in emergencies)

Unfortunately, current treatments for ME/CFS are purely symptomatic in nature. This is why I even invite young people to protect themselves against SARS-CoV-2 by getting vaccinated and wearing an FFP2 mask.“, she 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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