Ryabkova, Varvara A, Rubinskiy, Artemiy V, Marchenko, Valeriy N et al. · Pathophysiology : the official journal of the International Society for Pathophysiology · 2024 · DOI
This study found that people with ME/CFS and those with long COVID have similar problems with how their autonomic nervous system (the system that controls heart rate, blood pressure, and other automatic body functions) works. Researchers measured heart rate variability and blood pressure patterns in 34 ME/CFS patients, 29 long COVID patients, and 32 healthy controls. Both patient groups showed reduced autonomic function compared to healthy people, and these problems were linked to their fatigue—but not to depression or anxiety.
This research provides objective physiological evidence that ME/CFS and long COVID share common autonomic nervous system dysfunction, which helps validate these conditions and suggests they may benefit from similar autonomic-focused treatments. Understanding that autonomic dysfunction—not psychiatric illness—drives fatigue could shift clinical approaches and improve recognition of these diseases.
This study cannot establish causation or determine whether autonomic dysfunction causes fatigue or results from it. Cross-sectional design means it captures a single moment in time and cannot track how autonomic function changes over disease course. The findings do not prove that all ME/CFS and long COVID cases have identical mechanisms or that autonomic dysfunction is the sole pathophysiological driver of these conditions.
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
Ryabkova, Varvara A, Rubinskiy, Artemiy V, Marchenko, Valeriy N, Trofimov, Vasiliy I, & Churilov, Leonid P (2024). Similar Patterns of Dysautonomia in Myalgic Encephalomyelitis/Chronic Fatigue and Post-COVID-19 Syndromes.. Pathophysiology : the official journal of the International Society for Pathophysiology. https://doi.org/10.3390/pathophysiology31010001
BibTeX
@article{mecfsatlas-ryabkova-2024-similar-patterns,
author = {Ryabkova, Varvara A and Rubinskiy, Artemiy V and Marchenko, Valeriy N and Trofimov, Vasiliy I and Churilov, Leonid P},
title = {Similar Patterns of Dysautonomia in Myalgic Encephalomyelitis/Chronic Fatigue and Post-COVID-19 Syndromes.},
journal = {Pathophysiology : the official journal of the International Society for Pathophysiology},
year = {2024},
doi = {10.3390/pathophysiology31010001},
note = {PubMed: 38251045},
url = {https://www.mecfsatlas.com/evidence/ryabkova-2024-similar-patterns},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/ryabkova-2024-similar-patterns
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