Maes, Michael, Al-Rubaye, Haneen Tahseen, Almulla, Abbas F et al. · International journal of environmental research and public health · 2022 · DOI
This study found that Long COVID patients have significantly lower quality of life compared to healthy people, and this decline is mostly explained by three factors: mood and pain-related symptoms (like depression, anxiety, and fatigue), signs of ongoing inflammation in the body, and problems with how the body processes calcium. The severity of the initial infection—measured by high fever and low oxygen levels—also plays a role by triggering these inflammatory and immune problems that persist afterward.
This study identifies specific inflammatory and immune markers associated with quality of life impairment in Long COVID, potentially offering targets for intervention and helping clinicians understand why some patients experience severe functional decline. For ME/CFS research, it provides evidence that overlapping neuro-immune and oxidative stress pathways may underlie both the acute infectious trigger and persistent post-viral symptoms.
This cross-sectional design cannot prove causation—it shows associations between markers and quality of life, not that inflammation definitively causes reduced quality of life. The study does not establish whether treating the identified biomarkers would improve quality of life in patients. Results are correlational and cannot determine whether biomarker changes precede or follow symptom development in individual patients.
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
Maes, Michael, Al-Rubaye, Haneen Tahseen, Almulla, Abbas F, Al-Hadrawi, Dhurgham Shihab, Stoyanova, Kristina, Kubera, Marta, et al. (2022). Lowered Quality of Life in Long COVID Is Predicted by Affective Symptoms, Chronic Fatigue Syndrome, Inflammation and Neuroimmunotoxic Pathways.. International journal of environmental research and public health. https://doi.org/10.3390/ijerph191610362
BibTeX
@article{mecfsatlas-maes-2022-lowered-quality,
author = {Maes, Michael and Al-Rubaye, Haneen Tahseen and Almulla, Abbas F and Al-Hadrawi, Dhurgham Shihab and Stoyanova, Kristina and Kubera, Marta and Al-Hakeim, Hussein Kadhem},
title = {Lowered Quality of Life in Long COVID Is Predicted by Affective Symptoms, Chronic Fatigue Syndrome, Inflammation and Neuroimmunotoxic Pathways.},
journal = {International journal of environmental research and public health},
year = {2022},
doi = {10.3390/ijerph191610362},
note = {PubMed: 36011997},
url = {https://www.mecfsatlas.com/evidence/maes-2022-lowered-quality},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/maes-2022-lowered-quality
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