Evidence browser

Parent-child discrepancies in health-related quality of life of children and adolescents with myalgic encephalomyelitis/chronic fatigue syndrome.

Ekberg, Krista M, Torres, Chelsea, Jason, Leonard A·Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation·2021

This study looked at whether parents and their children with ME/CFS report symptoms and quality of life differently. Researchers compared 75 families where children had ME/CFS and 72 families without the condition, asking both parents and children to describe the child's health and symptoms. They found that parents and children often gave different answers, suggesting that both perspectives are important for understanding how ME/CFS affects young people.

Limbic Perfusion Is Reduced in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Li, Xia, Julin, Per, Li, Tie-Qiang·Tomography (Ann Arbor, Mich.)·2021

Researchers used a specialized brain imaging technique to measure blood flow in the brains of ME/CFS patients and compared it to healthy people. They found that patients with ME/CFS have reduced blood flow in several areas of the limbic system—the part of the brain that helps control emotions, automatic body functions, and memory. The amount of reduced blood flow was also linked to how severe patients' symptoms were.

E2 ModerateBehavioralPEM unclearCross-Sectional

How common are depression and anxiety in adolescents with chronic fatigue syndrome (CFS) and how should we screen for these mental health co-morbidities? A clinical cohort study.

Loades, Maria E, Read, Rebecca, Smith, Lucie et al.·European child & adolescent psychiatry·2021

This study looked at how common depression and anxiety are in teenagers with ME/CFS. Researchers interviewed 164 young people with ME/CFS and their parents using detailed diagnostic interviews and questionnaires. They found that about 1 in 3 teenagers had depression or anxiety, which is higher than expected. However, the questionnaires commonly used to screen for these conditions were not always accurate at detecting problems in this group, so doctors need to be careful and do thorough assessments rather than relying on questionnaires alone.

E2 ModerateBehavioralPEM unclearObservational

Towards personalized assessment of fatigue perpetuating factors in patients with chronic fatigue syndrome using ecological momentary assessment: A pilot study.

Worm-Smeitink, Margreet, Monden, Rei, Groen, Robin Nikita et al.·Journal of psychosomatic research·2021

Researchers tracked what 50 ME/CFS patients experienced throughout their day—their thoughts, activities, and mood—five times daily using phones and activity monitors. They found that two main patterns seemed connected to fatigue: feeling psychologically uncomfortable and how much patients were moving around. However, these patterns looked different for each person, and knowing about them didn't clearly predict who would improve with cognitive behavioural therapy (CBT).

The maintained attention assessment in patients affected by Myalgic encephalomyelitis/chronic fatigue syndrome: a reliable biomarker?

Murga, Iñigo, Aranburu, Larraitz, Gargiulo, Pascual A et al.·Journal of translational medicine·2021

This study looked at attention problems in ME/CFS patients by giving them a simple attention test (the Toulouse-Piéron test) and comparing their results to healthy people. Most ME/CFS patients had normal overall thinking skills, but 70% showed very low attention scores and complained of mental fatigue. Women with ME/CFS reported feeling more effort during the test than men did, even though their attention scores were similar.

Biomarkers

Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome.

Jimeno-Almazán, Amaya, Pallarés, Jesús G, Buendía-Romero, Ángel et al.·Journal of clinical medicine·2021

Some people who recover from COVID-19 experience persistent fatigue and difficulty exercising for months afterward. This study tested 32 people with long-lasting COVID symptoms and found that about 12% had a specific heart problem called chronotropic incompetence—their heart rate doesn't increase normally during exercise. This heart rhythm problem may explain why some patients struggle with exercise intolerance after COVID-19.

E2 ModerateCohortPEM unclearObservational

Beyond bones: The relevance of variants of connective tissue (hypermobility) to fibromyalgia, ME/CFS and controversies surrounding diagnostic classification: an observational study.

Eccles, Jessica A, Thompson, Beth, Themelis, Kristy et al.·Clinical medicine (London, England)·2021

This study looked at whether joint hypermobility (unusual flexibility and loose joints) is connected to fibromyalgia and ME/CFS. Researchers found that most patients with these conditions also had signs of hypermobility, and that higher hypermobility scores matched with worse symptoms. The results suggest that hypermobility is often missed in diagnosis, even though it significantly affects how sick people feel.

Diagnostics

E2 ModerateCohortPEM requiredCase-Control

Female Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome or Idiopathic Chronic Fatigue: Comparison of Responses to a Two-Day Cardiopulmonary Exercise Testing Protocol.

van Campen, C Linda M C, Visser, Frans C·Healthcare (Basel, Switzerland)·2021

This study tested whether people with ME/CFS and people with chronic fatigue (but not ME/CFS) respond differently to exercise on two consecutive days. Researchers had 50 women with ME/CFS and 51 women with chronic fatigue perform exercise tests while measuring oxygen use and heart rate. Women with ME/CFS performed worse on day 2, while women with chronic fatigue actually performed slightly better, suggesting ME/CFS creates a unique pattern of exercise intolerance.

E2 ModerateCohortPEM requiredObservational

Markers of Cardiac Autonomic Function During Consecutive Day Peak Exercise Tests in People With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Nelson, Maximillian J, Buckley, Jonathan D, Thomson, Rebecca L et al.·Frontiers in physiology·2021

This study looked at how the hearts of ME/CFS patients respond to exercise on two consecutive days, comparing them to healthy people. Researchers measured heart rate patterns and recovery after exercise, finding that ME/CFS patients had slower heart rate recovery after working out. However, these measurements alone were not reliable enough to diagnose ME/CFS, suggesting that a single heart rate test may not be a useful diagnostic tool on its own.

E2 ModerateCohortPEM not requiredLongitudinal

Inflammation-type dysbiosis of the oral microbiome associates with the duration of COVID-19 symptoms and long COVID.

Haran, John P, Bradley, Evan, Zeamer, Abigail L et al.·JCI insight·2021

This study looked at bacteria in the mouth of people with COVID-19 to understand why some people develop long COVID. Researchers found that people with long COVID had higher levels of inflammation-causing bacteria, particularly types called Prevotella and Veillonella. Interestingly, the oral bacteria patterns in long COVID patients resembled those seen in chronic fatigue syndrome patients, suggesting the microbiome may play a role in prolonged illness.

Immune System

Characterizing long COVID in an international cohort: 7 months of symptoms and their impact.

Davis, Hannah E, Assaf, Gina S, McCorkell, Lisa et al.·EClinicalMedicine·2021

This study surveyed nearly 3,800 people from around the world who had long-lasting COVID-19 symptoms lasting more than 28 days. By seven months after illness onset, most participants had not fully recovered and experienced an average of 56 symptoms affecting multiple body systems. The three most persistent symptoms were fatigue, post-exertional malaise (feeling worse after activity), and cognitive problems, with nearly 86% experiencing relapses triggered by exercise, physical activity, mental stress, or other exertion.

Postural orthostatic tachycardia syndrome in patients of orthostatic intolerance symptoms: an ambispective study.

Chouksey, Dinesh, Rathi, Pankaj, Sodani, Ajoy et al.·AIMS neuroscience·2021

This study looked at patients who experience dizziness, fainting, or heart racing when standing up—symptoms of a condition called POTS (Postural Orthostatic Tachycardia Syndrome). Researchers tested 246 patients with these symptoms and confirmed POTS in 40 of them using a special tilt-table test. Most POTS patients experienced fainting, lightheadedness, and heart palpitations, and nearly half also had a related condition causing fainting.

E2 ModerateCohortPEM unclearObservational

Possible involvement of the autonomic nervous system in cervical muscles of patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS).

Matsui, Takayoshi, Hara, Kazuhiro, Iwata, Makoto et al.·BMC musculoskeletal disorders·2021

This study looked at 1,226 hospitalized ME/CFS patients who received daily physical therapy focused on neck muscles. About 55% of patients recovered from ME/CFS after this treatment, and those who recovered showed changes in pupil size suggesting their nervous system function improved. The findings suggest that neck muscle problems and nervous system dysfunction may be connected in ME/CFS.

SleepCognitive Impairment

Long COVID and chronic fatigue syndrome: A survey of elderly female survivors in Egypt.

Aly, Menna A E G, Saber, Heba G·International journal of clinical practice·2021

This study looked at 115 elderly women in Egypt who had recovered from COVID-19 to see if their lingering symptoms might lead to chronic fatigue syndrome (ME/CFS). Most women reported problems like fatigue, muscle pain, and sleep trouble after COVID, and the study found that stress, sadness, and poor sleep were most strongly linked to developing CFS-like symptoms. Only one person in the study actually met full criteria for probable CFS, but the researchers suggest doctors should watch for these warning signs in long COVID patients.

E2 ModerateCohortPEM requiredCase-Control

Hypothalamic-Pituitary Autoimmunity and Related Impairment of Hormone Secretions in Chronic Fatigue Syndrome.

De Bellis, Annamaria, Bellastella, Giuseppe, Pernice, Vlenia et al.·The Journal of clinical endocrinology and metabolism·2021

This study looked for specific immune system antibodies that attack the pituitary and hypothalamus—two small brain structures that control hormone production—in people with ME/CFS. Researchers found these antibodies in more than half of ME/CFS patients but none in healthy controls. Patients with these antibodies had lower levels of important hormones (like cortisol and growth hormone), and those with the highest antibody levels had the most severe ME/CFS symptoms.

Immune System

E2 ModerateCohortPEM unclearObservational

Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Greatly Improved Fatigue Symptoms When Treated with Oxygen-Ozone Autohemotherapy.

Tirelli, Umberto, Franzini, Marianno, Valdenassi, Luigi et al.·Journal of clinical medicine·2021

This study tested whether a treatment called oxygen-ozone autohemotherapy (a procedure where blood is drawn, treated with ozone gas, and returned to the body) could help ME/CFS patients with fatigue. Among 200 patients treated, most experienced significant improvements in their fatigue levels within 30 days, with nearly half reporting the best possible improvement on a fatigue scale. No serious side effects were reported.

Complement Component C1q as a Potential Diagnostic Tool for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Subtyping.

Castro-Marrero, Jesús, Zacares, Mario, Almenar-Pérez, Eloy et al.·Journal of clinical medicine·2021

Researchers analyzed blood samples from 250 women with ME/CFS to see if specific blood markers could help identify different types of the disease. They found that about 43% of participants had high levels of a protein called C1q, which was particularly associated with those experiencing more pain symptoms. This discovery suggests that blood tests might one day help doctors identify which ME/CFS patients belong to which subgroup, potentially leading to better tailored treatments.

Immune System

Use of Cardiopulmonary Stress Testing for Patients With Unexplained Dyspnea Post-Coronavirus Disease.

Mancini, Donna M, Brunjes, Danielle L, Lala, Anuradha et al.·JACC. Heart failure·2021

This study looked at 41 people who had long-lasting breathing problems after COVID-19, even though their standard lung and heart tests appeared normal. Researchers used a special exercise test to measure how well their bodies could use oxygen and how they breathed during activity. They found that most patients had unusual breathing patterns or reduced exercise capacity, and about half met the criteria for ME/CFS.

E2 ModerateCohortPEM not requiredLongitudinal

Association between chronic fatigue syndrome and suicidality among survivors of Middle East respiratory syndrome over a 2-year follow-up period.

Ahn, So-Hyun, Kim, Jeong Lan, Kim, Jang Rae et al.·Journal of psychiatric research·2021

This study followed people who recovered from MERS (a serious respiratory illness) for 2 years to see if chronic fatigue increased their risk of suicidal thoughts. Researchers found that people who had chronic fatigue were about 7.5 times more likely to experience suicidal thoughts than those without fatigue. This connection remained strong even when accounting for other factors that might affect mental health.

E2 ModerateCohortPEM requiredLongitudinal

COVID-19 Symptoms Over Time: Comparing Long-Haulers to ME/CFS.

Jason, Leonard A, Islam, Mohammed, Conroy, Karl et al.·Fatigue : biomedicine, health & behavior·2021

This study compared how symptoms change over time in people with long COVID versus people with ME/CFS. Researchers asked 278 long-haulers to describe their current symptoms and symptoms from about 5 months earlier, and compared them to 502 ME/CFS patients. They found that long-haulers generally improved over time, with better sleep and less post-exertional malaise, but their brain fog and memory problems actually got worse. Long-haulers started off more symptomatic than ME/CFS patients but became less symptomatic over time, though orthostatic symptoms (dizziness when standing) remained similar in both groups.