Evidence browser

Mitochondrial Dysfunction and Coenzyme Q10 Supplementation in Post-Viral Fatigue Syndrome: An Overview.

Mantle, David, Hargreaves, Iain Parry, Domingo, Joan Carles et al.·International journal of molecular sciences·2024

This review examines whether problems with mitochondria—the energy-producing structures inside our cells—contribute to post-viral fatigue conditions like ME/CFS, long COVID, and fibromyalgia. The researchers looked at existing research to see if a supplement called Coenzyme Q10 might help reduce fatigue and pain by supporting mitochondrial function. While mitochondrial dysfunction appears linked to these conditions, more research is needed to confirm whether CoQ10 supplementation is an effective treatment.

Physical Activity and Fatigue Symptoms: Neurotypical Adults and People with Chronic Multisymptom Illnesses.

Boruch, Alex, Branchaw, Grace, O'Connor, Patrick J et al.·Current topics in behavioral neurosciences·2024

This review examined how physical activity affects fatigue in people with ME/CFS and similar long-term illnesses, compared to healthy people. In healthy adults, exercise usually makes people feel more energized, but in people with ME/CFS and related conditions, exercise often makes fatigue worse. Short-term exercise programs show small improvements in fatigue for healthy people, but little to no improvement for those with these chronic illnesses.

Developing effective strategies to optimize physical activity and cardiorespiratory fitness in the long Covid population- The need for caution and objective assessment.

Faghy, Mark A, Duncan, Rae, Hume, Emily et al.·Progress in cardiovascular diseases·2024

Long Covid affects millions of people worldwide with over 200 recognized symptoms that severely impact daily life. A key feature is post-exertional malaise (PEM)—a condition where symptoms dramatically worsen 24-72 hours after physical, mental, or emotional activity, sometimes lasting weeks. This review examines how to safely design rehabilitation programs for Long Covid patients while using objective monitoring tools to track how individuals respond to different activities and prevent symptom flare-ups.

E0 ConsensusReviewPEM unclearEditorial

How to understand the overlap of long COVID, chronic fatigue syndrome/myalgic encephalomyelitis, fibromyalgia and irritable bowel syndromes.

Goldenberg, Don L·Seminars in arthritis and rheumatism·2024

This study examines how long COVID, ME/CFS, fibromyalgia, and irritable bowel syndrome are similar conditions that all affect the nervous system and immune system together. Rather than being separate diseases, these conditions share common features and may work through the same underlying biological mechanisms. The researchers reviewed existing evidence and found striking similarities in how these conditions develop and affect patients.

E0 ConsensusReviewPEM not requiredReview-Narrative

Identifying microRNAs Possibly Implicated in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia: A Review.

Tsamou, Maria, Kremers, Fabiënne A C, Samaritakis, Keano A et al.·International journal of molecular sciences·2024

This review examined tiny molecules called microRNAs that may play a role in ME/CFS and fibromyalgia. Researchers looked at existing studies to identify which microRNAs appear to be abnormal in these conditions and what role they might play in causing symptoms. They found that certain microRNAs may be involved in immune system problems, energy production difficulties, and increased pain sensitivity—processes that could help explain why people with these diseases experience fatigue, pain, and other symptoms.

BiomarkersImmune System

Autoimmune Autonomic Neuropathy: From Pathogenesis to Diagnosis.

Nakane, Shunya, Koike, Haruki, Hayashi, Tomohiro et al.·International journal of molecular sciences·2024

This review describes autoimmune autonomic ganglionopathy (AAG), a rare condition where the immune system attacks nerve cells that control automatic body functions like heart rate and blood pressure. The authors explain how doctors can diagnose AAG and how it differs from other similar conditions, including ME/CFS and long COVID, which can have overlapping symptoms.

Autonomic Nervous SystemDiagnostics

[Multimodal Treatment Strategies for Homebound Patients with Severe ME/CFS: A Scoping Review].

Mayer-Huber, Sandra, Kircher, Alissa, Eberhartinger, Maria et al.·Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))·2024

This review looked at 14 published studies about ways to treat people with severe ME/CFS who are homebound or bedbound. The researchers found that the most helpful approaches were either home visits from healthcare providers or telemedicine (video/phone appointments). The studies highlighted that treatment works best when it's flexible, tailored to each person's daily needs, and includes family members in the care plan.

E0 ConsensusReviewPEM not requiredSystematic-Review

Brain-regional characteristics and neuroinflammation in ME/CFS patients from neuroimaging: A systematic review and meta-analysis.

Lee, Jin-Seok, Sato, Wakiro, Son, Chang-Gue·Autoimmunity reviews·2024

Researchers combined results from 65 brain imaging studies involving over 1,500 ME/CFS patients to look for signs of inflammation in the brain. They used four different types of brain scans and found that specific brain regions—particularly the insular and thalamic regions that help process emotions and manage body functions—showed reduced activity in ME/CFS patients compared to healthy controls. These findings suggest that problems in how these brain regions communicate may help explain why ME/CFS causes fatigue and other characteristic symptoms.

Neuroinflammation

L-Carnitine in the Treatment of Psychiatric and Neurological Manifestations: A Systematic Review.

Wang, Wenbo, Pan, Da, Liu, Qi et al.·Nutrients·2024

Researchers reviewed 60 studies about whether L-carnitine, a natural supplement, might help with nervous system and mental health problems. They found it showed promise for some conditions like stroke and Alzheimer's disease, but had limited effectiveness for others including chronic fatigue syndrome, depression, and ALS. This review summarizes what we currently know about L-carnitine's potential benefits and limitations across different neurological conditions.

E0 ConsensusReviewPEM not requiredGuideline

Celiac Disease-Related Conditions: Who to Test?

Zingone, Fabiana, Bai, Julio C, Cellier, Christophe et al.·Gastroenterology·2024

This review looked at which patients should be tested for celiac disease, a condition where the immune system reacts to gluten in food. The authors found that celiac disease is often missed and recommend testing in people with certain autoimmune diseases, digestive problems, thyroid disease, and other specific conditions—including chronic fatigue syndrome. They suggest blood tests first, with biopsies during endoscopy if needed to confirm the diagnosis.

Diagnostics

Energy MetabolismImmune System

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: the biology of a neglected disease.

Arron, Hayley E, Marsh, Benjamin D, Kell, Douglas B et al.·Frontiers in immunology·2024

This review examines what we know about ME/CFS by looking at how the disease develops from a combination of genetic factors, infections, and immune problems. The researchers found that ME/CFS appears to result from multiple body systems going wrong at the same time—including the immune system, inflammation, digestive health, and energy production. The study argues that doctors and scientists need to stop looking at ME/CFS as a single problem and instead understand it as a complex condition involving many interconnected issues.

E0 ConsensusReviewPEM requiredSystematic-Review

The persistence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) after SARS-CoV-2 infection: A systematic review and meta-analysis.

Dehlia, Ankush, Guthridge, Mark A·The Journal of infection·2024

Researchers looked at studies of people with Long COVID to see how many also meet the diagnostic criteria for ME/CFS. They found that about half of Long COVID patients have symptoms that match ME/CFS, including severe fatigue, sleep problems, muscle and joint pain, and post-exertional malaise (feeling much worse after physical activity). This suggests that Long COVID and ME/CFS may be very similar conditions, at least in some patients.

Severe MESleepPost-Exertional Malaise

E0 ConsensusReviewPEM unclear

Blood virome research in myalgic encephalomyelitis/chronic fatigue syndrome: challenges and opportunities.

Obraitis, Dominic, Li, Dawei·Current opinion in virology·2024

This review examines whether viruses trigger myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Scientists have found that some ME/CFS cases may start after viral infections, and blood tests can detect viral genetic material in patients. The review highlights that while viruses are a suspected cause, no single virus has been found in all ME/CFS patients, and researchers need better tools to understand these complex viral patterns.

Long COVID Overlap

NeuroinflammationImmune System

Recent Research Trends in Neuroinflammatory and Neurodegenerative Disorders.

Cohen, Jessica, Mathew, Annette, Dourvetakis, Kirk D et al.·Cells·2024

This review examines how inflammation in the brain and nervous system contributes to several chronic diseases, including ME/CFS and Gulf War Illness. The authors discuss how immune cells and inflammatory molecules can damage the brain and cause persistent symptoms. They highlight promising new laboratory techniques using human stem cells to create brain cells for testing potential treatments.

E0 ConsensusReviewPEM not requiredSystematic-Review

Ear abnormalities in chronic fatigue syndrome (CFS), fibromyalgia (FM), Coronavirus-19 infectious disease (COVID) and long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/inflammatory syndrome induced by adjuvants (ASIA): A systematic review.

Skare, Thelma L, de Carvalho, Jozélio Freire, de Medeiros, Italo Roberto Torres et al.·Autoimmunity reviews·2024

This review examined hearing and balance problems (including hearing loss, tinnitus, dizziness, and vertigo) reported across multiple conditions including ME/CFS, fibromyalgia, and long COVID. Researchers searched medical literature from 1990 to 2024 and found that while hearing problems are common, balance problems are less frequently reported. The study suggests these symptoms may stem from immune system dysfunction affecting the inner ear.

Immune System

Postacute Sequelae of SARS-CoV-2 in Children.

Rao, Suchitra, Gross, Rachel S, Mohandas, Sindhu et al.·Pediatrics·2024

Some children who have COVID-19 experience symptoms that last for weeks or months after the initial infection—a condition called long COVID. This review summarizes what we currently know about long COVID in children, including how common it is, what symptoms children experience, and what might cause it. The authors also describe major research efforts being funded to better understand long COVID in young people and find effective treatments.

Gut MicrobiomeImmune System

The impact of gut microbiome and diet on post-acute sequelae of SARS-CoV-2 infection.

Reyes, Zabrina, Stovall, Mary Catherine, Punyamurthula, Sanjana et al.·Journal of the neurological sciences·2024

This study looked at how gut bacteria and diet might affect people who develop Long COVID (symptoms that continue months after a COVID-19 infection). Researchers reviewed existing studies to see if changes in gut bacteria linked to worse COVID illness could be improved by eating foods rich in fiber and antioxidants, like those in the Mediterranean Diet. The idea is that a healthier gut might help prevent or reduce Long COVID symptoms.

E0 ConsensusGuidelinePEM requiredGuideline

Autoimmunity's enigmatic role: exploring the connection with myalgic encephalomyelitis/chronic fatigue syndrome.

Batham, Jacob, Dwyer, Jessica, Eaton-Fitch, Natalie et al.·BMC immunology·2024

Researchers reviewed 10 studies to understand whether ME/CFS is caused by autoimmunity—a condition where the immune system attacks the body's own cells. While some signs of autoimmune activity were found in ME/CFS patients, the evidence is mixed and not strong enough to confirm that autoimmunity is the main cause. The authors conclude that ME/CFS is more complex than a straightforward autoimmune disease.

Immune System

[Interdisciplinary, collaborative D-A-CH (Germany, Austria and Switzerland) consensus statement concerning the diagnostic and treatment of myalgic encephalomyelitis/chronic fatigue syndrome].

Hoffmann, Kathryn, Hainzl, Astrid, Stingl, Michael et al.·Wiener klinische Wochenschrift·2024

This is a clinical guidance document created by doctors and experts from Germany, Austria, and Switzerland to help diagnose and treat ME/CFS. The document emphasizes that ME/CFS is a serious, long-term illness affecting multiple body systems, and highlights post-exertional malaise (PEM)—where symptoms worsen after physical or mental effort—as the key symptom to recognize. The guide provides doctors with practical tools like questionnaires and examination methods to accurately diagnose ME/CFS, and describes two main treatment approaches: pacing (carefully managing activity levels) and symptom relief.