Gottschalk, Carl Gunnar, Peterson, Daniel, Armstrong, Jan et al. · Infectious agents and cancer · 2023 · DOI
This review article examines how viral infections—including long COVID, EBV, and others—can trigger severe, lasting fatigue and related symptoms. The authors explore the biological mechanisms that might explain why some patients develop chronic muscle fatigue and brain fog after viral illness, and compare these processes to ME/CFS. This research suggests that multiple different viruses may cause fatigue through similar pathways in the body.
This work is important because it identifies potential shared molecular mechanisms across ME/CFS and post-viral fatigue syndromes, which could guide future research into treatments applicable to multiple conditions. Understanding these commonalities may help researchers and clinicians recognize ME/CFS as a post-viral phenomenon with clear biological underpinnings rather than a psychiatric disorder. The review provides a framework for investigating why some patients progress from acute infection to chronic debilitating fatigue.
This review article does not prove causation or present new experimental evidence—it synthesizes existing literature and proposes hypothetical mechanisms. It does not establish which molecular pathways are primary drivers versus secondary consequences of fatigue, nor does it validate proposed mechanisms in ME/CFS or long COVID patients. The overlap in clinical symptoms between conditions does not prove they share identical biological origins.
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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