Grach, Stephanie L, Seltzer, Jaime, Chon, Tony Y et al. · Mayo Clinic proceedings · 2023 · DOI
This review explains how doctors can diagnose and manage ME/CFS, a serious illness that causes extreme tiredness and other symptoms, often starting after an infection. The authors note that ME/CFS shares many similarities with long COVID, the condition some people experience after having COVID-19. They provide practical guidance to help healthcare providers recognize and treat this condition.
This guideline is important because it addresses a critical gap in clinical practice by providing generalists with clear diagnostic and management strategies for ME/CFS, a disease often underrecognized or misdiagnosed. Given the substantial overlap with post-COVID syndrome affecting millions of patients, this guidance has broad relevance for improving patient care and reducing diagnostic delays.
This review does not establish new causal mechanisms of ME/CFS or prove the effectiveness of specific treatments through clinical trial data. It does not demonstrate differences between ME/CFS and post-COVID syndrome, only their overlap, and cannot determine whether they represent the same underlying condition.
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
Grach, Stephanie L, Seltzer, Jaime, Chon, Tony Y, & Ganesh, Ravindra (2023). Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Mayo Clinic proceedings. https://doi.org/10.1016/j.mayocp.2023.07.032
BibTeX
@article{mecfsatlas-grach-2023-diagnosis-management,
author = {Grach, Stephanie L and Seltzer, Jaime and Chon, Tony Y and Ganesh, Ravindra},
title = {Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Mayo Clinic proceedings},
year = {2023},
doi = {10.1016/j.mayocp.2023.07.032},
note = {PubMed: 37793728},
url = {https://www.mecfsatlas.com/evidence/grach-2023-diagnosis-management},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/grach-2023-diagnosis-management
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