Jinushi, Ryuhei, Nishiguchi, Sho, Masuda, Sakue et al. · Clinical case reports · 2023 · DOI
This study describes a patient who developed ME/CFS after recovering from COVID-19. The researchers found that this patient had lower-than-normal levels of acylcarnitine, a substance the body uses to produce energy. The study reviews existing research on how COVID-19 can lead to ME/CFS, a condition that causes severe fatigue and symptoms that worsen after physical activity.
This research is important because ME/CFS is difficult to diagnose and lacks established blood tests, making any potential biomarker valuable for patients seeking confirmation of their condition. The connection between COVID-19 and ME/CFS development is increasingly recognized clinically, and identifying metabolic abnormalities like low acylcarnitine may help explain the underlying mechanism of post-exertional malaise.
This case report cannot prove that low acylcarnitine causes ME/CFS or that it occurs in all post-COVID-19 ME/CFS patients—it describes only one individual. The study does not establish whether reduced acylcarnitine is a reliable diagnostic marker or whether it is specific to post-viral ME/CFS versus other conditions. Causation cannot be inferred from a single case observation.
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
Jinushi, Ryuhei, Nishiguchi, Sho, Masuda, Sakue, Sasaki, Akiko, Koizumi, Kazuya, & Ryozawa, Shomei (2023). A case of post-COVID-19 myalgic encephalomyelitis/chronic fatigue syndrome characterized by post-exertional malaise and low serum acylcarnitine level.. Clinical case reports. https://doi.org/10.1002/ccr3.6930
BibTeX
@article{mecfsatlas-jinushi-2023-case-post,
author = {Jinushi, Ryuhei and Nishiguchi, Sho and Masuda, Sakue and Sasaki, Akiko and Koizumi, Kazuya and Ryozawa, Shomei},
title = {A case of post-COVID-19 myalgic encephalomyelitis/chronic fatigue syndrome characterized by post-exertional malaise and low serum acylcarnitine level.},
journal = {Clinical case reports},
year = {2023},
doi = {10.1002/ccr3.6930},
note = {PubMed: 36789311},
url = {https://www.mecfsatlas.com/evidence/jinushi-2023-case-post},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/jinushi-2023-case-post
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