Dotan, Arad, David, Paula, Arnheim, Dana et al. · Autoimmunity reviews · 2022 · DOI
After COVID-19 infection, many people experience long-lasting symptoms similar to ME/CFS, including fatigue, brain fog, and mood problems. Recent research suggests the immune system may attack nerve cells that control heart rate, blood pressure, and other automatic body functions, rather than just the virus itself. The authors propose that exercise therapy might be safer and more helpful than immunosuppressive drugs for treating these lingering post-COVID symptoms.
This review is significant for ME/CFS patients because it identifies potential shared immune mechanisms—particularly autoimmune autonomic dysfunction—between post-COVID syndrome and ME/CFS, which may lead to better understanding and treatment options. The suggestion that exercise therapy stabilizes autonomic function offers a non-pharmacological approach that could benefit both post-COVID and ME/CFS populations, though careful implementation is critical given concerns about post-exertional malaise.
This review does not establish causation between specific autoantibodies and symptoms; it presents association data. It does not provide direct comparison of treatment efficacy in controlled trials, so claims about exercise being 'safer and more effective' are theoretical rather than evidence-based. The parallel drawn between post-COVID syndrome and ME/CFS does not prove they share identical pathogenic mechanisms.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Dotan, Arad, David, Paula, Arnheim, Dana, & Shoenfeld, Yehuda (2022). The autonomic aspects of the post-COVID19 syndrome.. Autoimmunity reviews. https://doi.org/10.1016/j.autrev.2022.103071
BibTeX
@article{mecfsatlas-dotan-2022-autonomic-aspects,
author = {Dotan, Arad and David, Paula and Arnheim, Dana and Shoenfeld, Yehuda},
title = {The autonomic aspects of the post-COVID19 syndrome.},
journal = {Autoimmunity reviews},
year = {2022},
doi = {10.1016/j.autrev.2022.103071},
note = {PubMed: 35182777},
url = {https://www.mecfsatlas.com/evidence/dotan-2022-autonomic-aspects},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/dotan-2022-autonomic-aspects
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