Malkova, Annа, Kudryavtsev, Igor, Starshinova, Anna et al. · Pathogens (Basel, Switzerland) · 2021 · DOI
Some people develop long-term symptoms weeks or months after having a mild or even asymptomatic COVID-19 infection. This review found that fatigue, breathing problems, cough, and loss of smell are common in these cases, affecting about 30-60% of patients, mostly women. The researchers suggest these symptoms may be caused by the virus damaging the nervous system or triggering the immune system to attack nerve cells, similar to what happens in chronic fatigue syndrome.
This study is important because it highlights that ME/CFS-like symptoms can develop after apparently mild COVID-19 infections, particularly in women. Understanding potential autoimmune and neurological mechanisms could help explain why some patients develop severe post-viral fatigue syndromes and may guide future diagnostic and therapeutic approaches for both post-COVID and ME/CFS patients.
This systematic review does not prove that autoimmune neuronal damage causes post-COVID symptoms—it proposes this as a hypothesis based on symptom patterns. The study cannot establish causation or definitively link anosmia and female sex to PCS development; these are identified as associations only. The review also does not directly compare post-COVID syndrome with ME/CFS or establish they are the same 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
Malkova, Annа, Kudryavtsev, Igor, Starshinova, Anna, Kudlay, Dmitry, Zinchenko, Yulia, Glushkova, Anzhela, et al. (2021). Post COVID-19 Syndrome in Patients with Asymptomatic/Mild Form.. Pathogens (Basel, Switzerland). https://doi.org/10.3390/pathogens10111408
BibTeX
@article{mecfsatlas-malkova-2021-post-covid,
author = {Malkova, Annа and Kudryavtsev, Igor and Starshinova, Anna and Kudlay, Dmitry and Zinchenko, Yulia and Glushkova, Anzhela and Yablonskiy, Piotr and Shoenfeld, Yehuda},
title = {Post COVID-19 Syndrome in Patients with Asymptomatic/Mild Form.},
journal = {Pathogens (Basel, Switzerland)},
year = {2021},
doi = {10.3390/pathogens10111408},
note = {PubMed: 34832564},
url = {https://www.mecfsatlas.com/evidence/malkova-2021-post-covid},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/malkova-2021-post-covid
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