Choutka, Jan, Jansari, Viraj, Hornig, Mady et al. · Nature medicine · 2022 · DOI
This review explains that several different infections—not just COVID-19—can sometimes cause long-lasting illness in some people who recover from the initial infection. These post-infection conditions share similar symptoms and overlap with ME/CFS, suggesting they might have common underlying causes that scientists don't yet understand. The authors argue that researchers need to invest more effort in understanding why and how these mysterious long-term illnesses develop.
This work is important because it validates that long-term post-infection illness is a real, widespread phenomenon affecting multiple conditions—not unique to COVID-19—which may help normalize ME/CFS as a legitimate medical condition. By highlighting that different infections produce remarkably similar chronic syndromes, the review suggests shared underlying biological mechanisms might be discoverable, offering potential research directions applicable to ME/CFS patients. Understanding these common pathways could eventually lead to treatments applicable across multiple post-acute conditions.
This review does not establish what the actual biological mechanisms are behind these syndromes—it documents that they exist and overlap, but does not provide evidence of specific causal pathways. It does not prove that all post-acute infection syndromes have identical mechanisms, only that similarities warrant investigation. As an editorial review rather than original research, it does not present new experimental data proving causality.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Choutka, Jan, Jansari, Viraj, Hornig, Mady, & Iwasaki, Akiko (2022). Unexplained post-acute infection syndromes.. Nature medicine. https://doi.org/10.1038/s41591-022-01810-6
BibTeX
@article{mecfsatlas-choutka-2022-unexplained-post,
author = {Choutka, Jan and Jansari, Viraj and Hornig, Mady and Iwasaki, Akiko},
title = {Unexplained post-acute infection syndromes.},
journal = {Nature medicine},
year = {2022},
doi = {10.1038/s41591-022-01810-6},
note = {PubMed: 35585196},
url = {https://www.mecfsatlas.com/evidence/choutka-2022-unexplained-post},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/choutka-2022-unexplained-post
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