Sandler, Carolina X, Cvejic, Erin, Valencia, Braulio M et al. · Frontiers in neurology · 2022 · DOI
This study followed people who had acute viral infections (EBV, Ross River virus, or Q fever) to see who developed ME/CFS-like symptoms by 6 months. About 1 in 5 participants met CFS criteria. The researchers found that people who felt more severely ill during their acute infection, and those with mood problems during that time, were more likely to have prolonged fatigue and continued mood difficulties afterward.
This study identifies modifiable factors—baseline illness severity and mood disturbance—that occur early in infection and predict progression to ME/CFS, creating a window for early intervention. Understanding which people are at highest risk for post-infective fatigue could enable targeted clinical support and potentially prevent progression to chronic ME/CFS.
This study does not prove that mood disturbance *causes* prolonged fatigue, only that they co-occur and predict worse outcomes together. The study also does not establish whether the NPY gene variants influence ME/CFS risk in all populations, nor does it identify specific mechanisms by which acute illness severity leads to prolonged illness. Generalizability to non-viral infections or populations outside Australia is not established.
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
Sandler, Carolina X, Cvejic, Erin, Valencia, Braulio M, Li, Hui, Hickie, Ian B, & Lloyd, Andrew R (2022). Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection.. Frontiers in neurology. https://doi.org/10.3389/fneur.2022.935442
BibTeX
@article{mecfsatlas-sandler-2022-predictors-chronic,
author = {Sandler, Carolina X and Cvejic, Erin and Valencia, Braulio M and Li, Hui and Hickie, Ian B and Lloyd, Andrew R},
title = {Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection.},
journal = {Frontiers in neurology},
year = {2022},
doi = {10.3389/fneur.2022.935442},
note = {PubMed: 35959390},
url = {https://www.mecfsatlas.com/evidence/sandler-2022-predictors-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/sandler-2022-predictors-chronic
Contribute
Private, reviewed by a human. Not a public comment thread.