Katz, Ben Z, Collin, Simon M, Murphy, Gabrielle et al. · Fatigue : biomedicine, health & behavior · 2018 · DOI
COFFI is an international research project that combines data from thousands of patients across six countries who developed severe fatigue after different infections, such as mononucleosis, Q fever, and others. Researchers followed patients for up to 10 years to identify what factors predict who will recover and who will develop long-lasting fatigue syndromes. Early findings suggest that being female, having low physical fitness before infection, and experiencing problems with the autonomic nervous system increase the risk of prolonged fatigue.
COFFI represents the largest coordinated international effort to study post-infection fatigue using standardized criteria and long-term follow-up, offering unique power to identify common mechanisms across different infectious triggers and determine which patients are at highest risk for developing ME/CFS. Understanding predictive factors and comparing outcomes across infections may help clinicians identify at-risk individuals early and could illuminate whether ME/CFS represents a final common pathway from multiple infectious triggers.
This preliminary report does not establish causation for the identified risk factors—only associations with non-recovery. The study does not definitively answer whether different infections produce distinct ME/CFS phenotypes or whether the identified risk factors are modifiable. Being a registry, it lacks a true control group of infected individuals who recovered normally.
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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