Wirth, Klaus Josef, Löhn, Matthias · Medicina (Kaunas, Lithuania) · 2024 · DOI
This study proposes that ME/CFS may develop from COVID-19 in some people due to problems with how blood flows through tiny vessels in the body. The researchers suggest that abnormal blood cells and clots, combined with weak heart function and overly constricted blood vessels, create a double problem that starves muscles of oxygen and damages the energy-producing structures (mitochondria) inside cells. This combination may trigger a harmful cycle that keeps the problem going.
This study provides a testable mechanistic framework linking cardiovascular dysfunction, microvascular pathology, and mitochondrial dysfunction—three key findings in ME/CFS research. If accurate, it could guide development of targeted treatments addressing blood flow, clotting, and vascular tone rather than only symptom management. It also helps explain why some COVID-19 patients transition to severe, persistent ME/CFS while others recover.
This is a theoretical mechanistic proposal, not original experimental research, so it does not prove causation or validate these mechanisms in patient populations. The study does not establish whether microvascular disturbances are primary drivers of ME/CFS or secondary consequences of other pathology. It cannot determine treatment efficacy or which interventions would be most effective.
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
Wirth, Klaus Josef & Löhn, Matthias (2024). Microvascular Capillary and Precapillary Cardiovascular Disturbances Strongly Interact to Severely Affect Tissue Perfusion and Mitochondrial Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Evolving from the Post COVID-19 Syndrome.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina60020194
BibTeX
@article{mecfsatlas-wirth-2024-microvascular-capillary,
author = {Wirth, Klaus Josef and Löhn, Matthias},
title = {Microvascular Capillary and Precapillary Cardiovascular Disturbances Strongly Interact to Severely Affect Tissue Perfusion and Mitochondrial Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Evolving from the Post COVID-19 Syndrome.},
journal = {Medicina (Kaunas, Lithuania)},
year = {2024},
doi = {10.3390/medicina60020194},
note = {PubMed: 38399482},
url = {https://www.mecfsatlas.com/evidence/wirth-2024-microvascular-capillary},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/wirth-2024-microvascular-capillary
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