Vojdani, Aristo, Vojdani, Elroy, Saidara, Evan et al. · Viruses · 2023 · DOI
This review examines how long COVID—a condition where symptoms persist months after a coronavirus infection—may develop through similar mechanisms to ME/CFS. The authors suggest that viral persistence, reactivation of old herpes viruses (like Epstein-Barr virus), immune system dysfunction, and gut microbiome changes may all contribute to ongoing inflammation and autoimmune problems. They propose testing for antibodies and other markers to better identify and treat long COVID.
This review strengthens the connection between long COVID and ME/CFS by identifying shared biological mechanisms, suggesting that insights from ME/CFS research may inform long COVID management and vice versa. For ME/CFS patients, the proposed diagnostic markers could potentially improve early identification and stratification of disease subtypes. The multi-factorial framework validates patient experiences of complex, multi-system illness.
This review does not prove that viral persistence or herpesvirus reactivation *causes* long COVID or ME/CFS—it identifies associations and proposes mechanisms without definitive causal evidence. The proposed diagnostic tests are suggested but not validated clinically in this paper. This work does not establish that all long COVID cases follow the same pathogenic pathway.
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 →
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Primary citation
Vojdani, Aristo, Vojdani, Elroy, Saidara, Evan, & Maes, Michael (2023). Persistent SARS-CoV-2 Infection, EBV, HHV-6 and Other Factors May Contribute to Inflammation and Autoimmunity in Long COVID.. Viruses. https://doi.org/10.3390/v15020400
BibTeX
@article{mecfsatlas-vojdani-2023-persistent-sars,
author = {Vojdani, Aristo and Vojdani, Elroy and Saidara, Evan and Maes, Michael},
title = {Persistent SARS-CoV-2 Infection, EBV, HHV-6 and Other Factors May Contribute to Inflammation and Autoimmunity in Long COVID.},
journal = {Viruses},
year = {2023},
doi = {10.3390/v15020400},
note = {PubMed: 36851614},
url = {https://www.mecfsatlas.com/evidence/vojdani-2023-persistent-sars},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/vojdani-2023-persistent-sars
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