Kedor, Claudia, Freitag, Helma, Meyer-Arndt, Lil et al. · Nature communications · 2022 · DOI
This study followed 42 people with long-lasting fatigue after COVID-19 infection for six months and compared them to people with similar chronic fatigue from other causes. Most participants experienced moderate to severe fatigue that interfered with daily life. The researchers found that many of these post-COVID patients had reduced hand grip strength and blood markers suggesting possible inflammation and poor blood flow, which may help explain why their bodies struggle to recover.
This study demonstrates that a substantial proportion of post-COVID patients develop ME/CFS-like illness indistinguishable in severity from classical ME/CFS, helping validate post-COVID-19 fatigue as a legitimate clinical entity. The identification of specific biomarkers associated with symptom severity provides potential biological markers to guide future treatment development and could help distinguish post-COVID ME/CFS from other fatigue conditions.
This study does not prove that inflammation and hypoperfusion cause ME/CFS symptoms—only that they are associated with symptom severity. The small sample size and observational design limit generalizability and cannot establish whether these biomarkers are causes, consequences, or coincidental findings. Cross-sectional biomarker measurement does not establish temporal relationships or causal 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
Kedor, Claudia, Freitag, Helma, Meyer-Arndt, Lil, Wittke, Kirsten, Hanitsch, Leif G, Zoller, Thomas, et al. (2022). A prospective observational study of post-COVID-19 chronic fatigue syndrome following the first pandemic wave in Germany and biomarkers associated with symptom severity.. Nature communications. https://doi.org/10.1038/s41467-022-32507-6
BibTeX
@article{mecfsatlas-kedor-2022-prospective-observational,
author = {Kedor, Claudia and Freitag, Helma and Meyer-Arndt, Lil and Wittke, Kirsten and Hanitsch, Leif G and Zoller, Thomas and Steinbeis, Fridolin and Haffke, Milan and Rudolf, Gordon and Heidecker, Bettina and Bobbert, Thomas and Spranger, Joachim and Volk, Hans-Dieter and Skurk, Carsten and Konietschke, Frank and Paul, Friedemann and Behrends, Uta and Bellmann-Strobl, Judith and Scheibenbogen, Carmen},
title = {A prospective observational study of post-COVID-19 chronic fatigue syndrome following the first pandemic wave in Germany and biomarkers associated with symptom severity.},
journal = {Nature communications},
year = {2022},
doi = {10.1038/s41467-022-32507-6},
note = {PubMed: 36042189},
url = {https://www.mecfsatlas.com/evidence/kedor-2022-prospective-observational},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/kedor-2022-prospective-observational
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