Nunes, Massimo, Kell, Loren, Slaghekke, Anouk et al. · Cell death & disease · 2026 · DOI
This study proposes that ME/CFS and long COVID may be caused by damage to the blood vessels (endothelial cells) that occurs after a viral infection. When these cells become damaged and 'senescent' (aged), they release harmful substances that cause inflammation, blood clots, and reduced blood flow to the brain and other organs. The study suggests that a faulty immune system keeps these damaged blood vessels from healing, which is why symptoms persist for months or years after the initial infection.
This study provides a unifying biological mechanism that could explain why ME/CFS and long COVID share so many symptoms and why they persist so long. If endothelial senescence and immune dysfunction are indeed central to disease pathology, it opens new avenues for identifying biomarkers and developing targeted treatments that address the root cause rather than just symptoms.
This is a theoretical framework paper, not an empirical study with patient data or experimental validation. It does not prove that endothelial senescence causes ME/CFS, only proposes a plausible mechanism. Direct evidence linking virus-induced endothelial senescence to persistent immune dysregulation and clinical symptoms in ME/CFS patients remains to be established through prospective studies.
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
Nunes, Massimo, Kell, Loren, Slaghekke, Anouk, Wüst, Rob Ci, Fielding, Burtram C, Kell, Douglas B, et al. (2026). Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system.. Cell death & disease. https://doi.org/10.1038/s41419-025-08162-2
BibTeX
@article{mecfsatlas-nunes-2026-virus-induced,
author = {Nunes, Massimo and Kell, Loren and Slaghekke, Anouk and Wüst, Rob Ci and Fielding, Burtram C and Kell, Douglas B and Pretorius, Etheresia},
title = {Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system.},
journal = {Cell death & disease},
year = {2026},
doi = {10.1038/s41419-025-08162-2},
note = {PubMed: 41513611},
url = {https://www.mecfsatlas.com/evidence/nunes-2026-virus-induced},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/nunes-2026-virus-induced
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