Evidence browser

Epipharyngeal Abrasive Therapy (EAT) Has Potential as a Novel Method for Long COVID Treatment.

Imai, Kazuaki, Yamano, Takafumi, Nishi, Soichiro et al.·Viruses·2022

This study tested a Japanese treatment called epipharyngeal abrasive therapy (EAT) on 58 long COVID patients. The treatment involves applying zinc chloride to the back of the throat to reduce inflammation. Patients received weekly treatments for one month, and three common symptoms—fatigue, headaches, and difficulty concentrating—improved significantly after treatment.

Cognitive Impairment

Key Features of a Multi-Disciplinary Hospital-Based Rehabilitation Program for Children and Adolescents with Moderate to Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome ME/CFS.

Hiremath, Sonya, Doukrou, Montserrat, Flannery, Halina et al.·International journal of environmental research and public health·2022

This study looked at 27 children and teenagers with moderate to severe ME/CFS who stayed in a hospital and received coordinated care from multiple medical professionals. Most patients (85%) showed improvement in at least one important area of their lives, such as being able to move around better, return to school, sleep better, or enjoy social activities. These results suggest that hospital-based rehabilitation programs can help young people with severe ME/CFS improve their quality of life.

Sleep

E2 ModerateCohortPEM not requiredLongitudinal

Oxaloacetate Treatment For Mental And Physical Fatigue In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long-COVID fatigue patients: a non-randomized controlled clinical trial.

Cash, Alan, Kaufman, David Lyons·Journal of translational medicine·2022

This study tested whether a supplement called oxaloacetate could help reduce fatigue in ME/CFS and Long COVID patients. Over 6 weeks, patients taking oxaloacetate showed significant improvements in both mental and physical fatigue—with ME/CFS patients improving by 22–33% depending on dose, and Long COVID patients improving by up to 47%—compared to expected placebo improvements of about 6%.

Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection.

Sandler, Carolina X, Cvejic, Erin, Valencia, Braulio M et al.·Frontiers in neurology·2022

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.

E2 ModerateCohortPEM required

Volumetric differences in hippocampal subfields and associations with clinical measures in myalgic encephalomyelitis/chronic fatigue syndrome.

Thapaliya, Kiran, Staines, Donald, Marshall-Gradisnik, Sonya et al.·Journal of neuroscience research·2022

Researchers used brain imaging to examine a part of the brain called the hippocampus, which is important for memory and thinking. They found that people with ME/CFS who met stricter diagnostic criteria had some structural differences in specific regions of their hippocampus compared to healthy people, and these differences were connected to how severe their fatigue and pain were. This finding supports the idea that ME/CFS involves real physical changes in the brain that may explain memory and cognitive problems patients experience.

Cognitive Impairment

Causal attributions and perceived stigma for myalgic encephalomyelitis/chronic fatigue syndrome.

Froehlich, Laura, Hattesohl, Daniel Br, Cotler, Joseph et al.·Journal of health psychology·2022

This study looked at how ME/CFS patients are affected by what others think about their illness. Researchers found that when people believe others think ME/CFS is something the patient can control (like a psychological problem rather than a real disease), it increases feelings of shame and stigma. These negative feelings then lead to worse health outcomes and less satisfaction with daily activities.

E2 ModerateCohortPEM unclearCase-Control

Genetic and epigenetic regulation of Catechol-O-methyltransferase in relation to inflammation in chronic fatigue syndrome and Fibromyalgia.

Polli, Andrea, Hendrix, Jolien, Ickmans, Kelly et al.·Journal of translational medicine·2022

This study looked at how genes and chemical changes in DNA affect a protein called COMT, which plays a role in pain and inflammation in ME/CFS and fibromyalgia. Researchers compared 28 patients with these conditions to 26 healthy people and measured pain sensitivity, genetic variants, and immune markers. They found that certain genetic patterns and DNA changes were linked to symptoms and immune responses, suggesting that how our genes are "switched on or off" may contribute to these conditions.

E2 ModerateCohortPEM not requiredLongitudinal

Impact of a mid-urethral synthetic mesh sling on long-term risk of systemic conditions in women with stress urinary incontinence: a national cohort study.

Muller, P, Gurol-Urganci, I, Thakar, R et al.·BJOG : an international journal of obstetrics and gynaecology·2022

This study looked at whether a surgical mesh implant used to treat urinary leakage in women increases the risk of developing systemic diseases like autoimmune conditions, fibromyalgia, or ME/CFS. Researchers compared nearly 89,000 women who received mesh surgery to about 3,400 women who had surgery without mesh, following them for up to 10 years. The study found no evidence that mesh surgery increased the risk of these systemic conditions.

E2 ModerateCohortPEM unclearCross-Sectional

Long-term sequelae of COVID-19 (myalgic encephalomyelitis): An international cross-sectional study.

Shaheen, Nour, Shaheen, Ahmed·Medicine·2022

This study examined how COVID-19 affects people's health long after the initial infection, including whether some people develop ME/CFS (myalgic encephalomyelitis) as a result. Researchers planned to survey 20,000 people worldwide about their ongoing symptoms weeks to months after COVID-19 infection, using detailed questionnaires to capture a wide range of both common and unusual long-term effects. The goal was to understand who develops long-term problems and whether COVID-19 can trigger ME/CFS in previously healthy people.

Endothelial dysfunction and altered endothelial biomarkers in patients with post-COVID-19 syndrome and chronic fatigue syndrome (ME/CFS).

Haffke, Milan, Freitag, Helma, Rudolf, Gordon et al.·Journal of translational medicine·2022

This study looked at whether blood vessel function is damaged in people with long COVID and ME/CFS. Researchers tested blood vessel function and measured specific proteins in the blood that reflect endothelial (blood vessel lining) health. They found that some patients with both conditions showed signs of blood vessel dysfunction, and had abnormal levels of certain proteins compared to healthy people.

E2 ModerateCohortPEM requiredObservational

A 2-day cardiopulmonary exercise test in chronic fatigue syndrome patients who were exposed to humidifier disinfectants.

Leem, Jong-Han, Jeon, Hyoung-Eun, Nam, Hun et al.·Environmental analysis, health and toxicology·2022

This study tested whether a special two-day exercise test could detect post-exertional malaise (PEM)—the worsening of symptoms after physical activity—in people with ME/CFS who had been exposed to humidifier disinfectants. The researchers had 29 participants complete an exercise test, rest for 24 hours, then repeat it. They found that performance noticeably declined on the second day, showing that PEM is real and measurable.

E2 ModerateCohortPEM unclearLongitudinal

Physiological assessment of orthostatic intolerance in chronic fatigue syndrome.

Natelson, Benjamin H, Lin, Jin-Mann S, Blate, Michelle et al.·Journal of translational medicine·2022

This study tested how the bodies of ME/CFS patients respond when they shift from lying down to leaning upright for 10 minutes. Researchers measured heart rate, blood pressure, breathing, and carbon dioxide levels in the blood. They found that 60% of patients showed abnormal responses, with low blood carbon dioxide levels being the most common problem, followed by an excessively fast heartbeat when standing.

Autonomic Nervous System

A comparative study of valaciclovir, valganciclovir, and artesunate efficacy in reactivated HHV-6 and HHV-7 infections associated with chronic fatigue syndrome/myalgic encephalomyelitis.

Maltsev, Dmitry·Microbiology and immunology·2022

This study tested three antiviral medications in ME/CFS patients who had reactivated herpesvirus infections (HHV-6 and HHV-7). Over three months, the drug artesunate was more effective at clearing the virus from the blood than two other antivirals (valaciclovir and valganciclovir). By the third month, artesunate cleared the virus in about 68% of HHV-6 cases and 63% of HHV-7 cases, compared to 37% and 34% with valaciclovir.

Separating Patients with SEID from Those with CFS in the French ME/CFS Association, with Some Thoughts on Nomenclature.

Campagne, Julien, Fornasieri, Isabelle, Andreani, Barbara et al.·Diagnostics (Basel, Switzerland)·2022

Researchers surveyed French ME/CFS patients to see how many met the newer diagnostic criteria called SEID (Systemic Exertion Intolerance Disease), proposed in 2015. They found that about 84% of patients in the survey met SEID criteria, and certain symptoms like unrefreshing sleep, brain fog, and problems with blood pressure changes were especially useful for identifying SEID patients. However, most patients didn't strongly prefer the new SEID name over ME/CFS, suggesting the medical community should work with patients to find better terminology.

Diagnostics

Long COVID OverlapPost-Exertional Malaise

ME/CFS and Post-Exertional Malaise among Patients with Long COVID.

Jason, Leonard A, Dorri, Joseph A·Neurology international·2022

Researchers studied 465 people with long-term COVID symptoms to see how many also had ME/CFS (a serious condition causing extreme fatigue and worsening after activity). They found that about 6 in 10 people with long COVID met the medical criteria for ME/CFS. Interestingly, some people thought they had ME/CFS when they didn't, while others had ME/CFS without realizing it—showing that self-diagnosis alone isn't reliable.

E2 ModerateCohortPEM requiredObservational

Long-term neuromuscular consequences of SARS-Cov-2 and their similarities with myalgic encephalomyelitis/chronic fatigue syndrome: results of the retrospective CoLGEM study.

Retornaz, Frédérique, Rebaudet, Stanislas, Stavris, Chloé et al.·Journal of translational medicine·2022

This study found that long-COVID patients and ME/CFS patients have very similar symptoms and muscle problems. Researchers measured electrical activity in leg muscles during and after exercise in both groups and found comparable patterns of muscle fatigue. This suggests that COVID-19 infection may trigger ME/CFS-like illness in some people.

E2 ModerateDiagnosticPEM unclearMethods-Paper

Comparing Operationalized Approaches for Substantial Reduction of Functioning in Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

Wiedbusch, Elzbieta, Jason, Leonard A·Archives of community medicine·2022

This study looked at five different ways to measure how much ME/CFS reduces a person's ability to function in daily life—something that is a key part of diagnosis. Using a large international group of over 2,300 patients and 359 healthy controls, researchers found that all five methods worked reasonably well, but a simple single-question approach was the best at identifying who actually had ME/CFS. This suggests doctors could use an easier, faster method to assess this important symptom.

Diagnostics

E2 ModerateCohortPEM unclearCross-Sectional

Autoimmune gene expression profiling of fingerstick whole blood in Chronic Fatigue Syndrome.

Wang, Zheng, Waldman, Michelle F, Basavanhally, Tara J et al.·Journal of translational medicine·2022

Researchers tested blood samples from 166 ME/CFS patients and 83 healthy people to look for immune system clues that might explain the disease. They found that six specific genes related to immune function were more active in patients with severe, bedridden ME/CFS compared to those with milder disease. The study suggests these genes could potentially be used as biomarkers to identify how severe someone's ME/CFS is and might point toward new treatments.

BiomarkersImmune System

E2 ModerateCohortPEM requiredLongitudinal

Improvement of Long COVID symptoms over one year.

Oliveira, Carlos R, Jason, Leonard A, Unutmaz, Derya et al.·Frontiers in medicine·2022

This study compared people with Long COVID (PASC) to people with ME/CFS, conditions that cause similar symptoms like fatigue and brain fog. Over one year, people with Long COVID showed improvement in five key symptoms including fatigue and post-exertional malaise, while people with ME/CFS did not improve. The researchers used a symptom questionnaire to track changes and found that Long COVID and ME/CFS look similar at first, but Long COVID appears to follow a different course.