Evidence browser

E2 ModeratePEM unclearRegistry-Resource

Impact of COVID-19 on myalgic encephalomyelitis/chronic fatigue syndrome-like illness prevalence: A cross-sectional survey.

Wood, Mariah S, Halmer, Nicole, Bertolli, Jeanne et al.·PloS one·2024

This study found that about 1.67% of adults in a large California health system have ME/CFS-like illness. While COVID-19 can trigger ME/CFS in some people, only about 14% of those with ME/CFS-like illness developed it after having COVID-19. People with ME/CFS-like illness reported significant difficulties with physical activities, work, relationships, and mental health compared to those without the condition.

The German Multicenter Registry for ME/CFS (MECFS-R).

Hieber, Hannah, Pricoco, Rafael, Gerrer, Katrin et al.·Journal of clinical medicine·2024

German researchers created a registry to collect detailed health information from ME/CFS patients across multiple medical centers. In their first group of 174 patients, they found that most had a viral illness before developing ME/CFS, with nearly half triggered by COVID-19. Patients reported severe fatigue and greatly reduced quality of life, with significant limitations in daily activities.

Sex and disease severity-based analysis of steroid hormones in ME/CFS.

Pipper, Cornelia, Bliem, Linda, León, Luis E et al.·Journal of endocrinological investigation·2024

Researchers measured hormone levels in the blood of ME/CFS patients and compared them to healthy people. They found that certain hormones—including cortisol-related compounds and progesterone—were different in people with ME/CFS, and the differences varied depending on whether patients had mild/moderate or severe disease and their sex. These hormone patterns might help doctors better identify and categorize ME/CFS in the future.

Biomarkers

What is the occupational impact of myalgic encephalomyelitis/chronic fatigue syndrome for adults living in Australia?

Thomas, Roshni, Hughes, Julie, Kotzur, Cheryl·The British journal of occupational therapy·2024

This study looked at how ME/CFS affects the ability of Australian adults to work and participate in daily activities. Researchers surveyed 29 people with ME/CFS about their work, hobbies, and self-care routines using a standardized assessment tool. The results showed that people with ME/CFS experienced significant reductions in activities across all areas of life and reported feeling isolated, trapped, burdened, and disconnected from their former roles.

E2 ModerateBehavioralPEM not requiredCross-Sectional

The Head-Up Tilt Table Test as a Measure of Autonomic Functioning among Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Jason, Leonard A, McGarrigle, William J, Vermeulen, Ruud C W·Journal of personalized medicine·2024

This study tested 193 people with ME/CFS using a tilt table test to check if they had problems with their autonomic nervous system (the system that controls heart rate and blood pressure). About one in three participants showed signs of orthostatic intolerance—a condition where the body struggles to maintain proper blood pressure and heart rate when standing. People with these problems reported worse sleep, more severe post-exertional malaise (exhaustion after activity), and greater physical limitations.

Post-Exertional Malaise

Insomnia and sleep characteristics in post COVID-19 fatigue: A cross-sectional case-controlled study.

Rauwerda, Nynke L, Kuut, Tanja A, Braamse, Annemarie M J et al.·Journal of psychosomatic research·2024

This study looked at sleep problems in people with long COVID fatigue and compared them to people with ME/CFS. Researchers found that 64% of long COVID patients had clinically significant insomnia, and their sleep problems were closely linked to depression and age. While long COVID patients slept slightly less than ME/CFS patients on average, both groups struggled significantly with sleep quality and nighttime insomnia.

Sleep

The Cardiac Output-Cerebral Blood Flow Relationship Is Abnormal in Most Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients with a Normal Heart Rate and Blood Pressure Response During a Tilt Test.

van Campen, C Linda M C, Verheugt, Freek W A, Rowe, Peter C et al.·Healthcare (Basel, Switzerland)·2024

This study looked at how blood flow to the brain changes when ME/CFS patients stand up or tilt on a table. Researchers found that in 91% of patients, the heart wasn't pumping enough blood and the brain wasn't getting enough blood flow—and these two problems were directly connected. This suggests that blood vessels in the brain may not be working properly to compensate when blood flow drops, which could explain why many ME/CFS patients feel dizzy or faint when standing.

Autonomic Nervous System

Phase-dependent trends in the prevalence of myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) related to long COVID: A criteria-based retrospective study in Japan.

Morita, Satoru, Tokumasu, Kazuki, Otsuka, Yuki et al.·PloS one·2024

This study looked at 739 patients with long COVID to understand how many developed ME/CFS and what factors were involved. Researchers found that ME/CFS affected about 8% of long COVID patients, but the rate varied depending on which COVID variant caused the initial infection—it was much higher (24%) in early COVID but dropped significantly (3%) during the Omicron wave. Brain fog complaints increased over time, even as strict ME/CFS diagnoses became less common.

Cognitive Impairment

Do people with ME/CFS and joint hypermobility represent a disease subgroup? An analysis using registry data.

Mudie, Kathleen, Ramiller, Allison, Whittaker, Sadie et al.·Frontiers in neurology·2024

This study looked at whether ME/CFS patients with loose, flexible joints (joint hypermobility) form a distinct group with different symptoms and health impacts. Researchers surveyed 815 ME/CFS patients and found that about 16% had joint hypermobility. These patients reported worse quality of life, more pain, and more symptoms affecting their nervous system, thinking, digestion, and muscles compared to ME/CFS patients without joint hypermobility.

Autonomic Nervous System

Diverse immunological dysregulation, chronic inflammation, and impaired erythropoiesis in long COVID patients with chronic fatigue syndrome.

Saito, Suguru, Shahbaz, Shima, Osman, Mohammed et al.·Journal of autoimmunity·2024

This study compared blood samples from long COVID patients with ME/CFS to those who fully recovered from COVID-19. Researchers found that ME/CFS patients had unusual patterns in their immune cells and higher levels of inflammation-promoting substances in their blood. They also discovered specific immune markers that could reliably distinguish ME/CFS patients from those who recovered, suggesting these markers could potentially be used for diagnosis.

Immune System

E2 ModerateCohortPEM not requiredObservational

Dry eye symptoms and signs in United States Gulf War era veterans with myalgic encephalomyelitis/chronic fatigue syndrome.

Sanchez, Victor, Kim, Colin K, Locatelli, Elyana V T et al.·Clinical & experimental ophthalmology·2024

Researchers studied eye dryness and discomfort in Gulf War veterans with ME/CFS and compared them to veterans without the condition. They found that people with ME/CFS reported significantly more eye pain and dryness symptoms, even though physical examination of their eyes showed similar amounts of tear production and surface damage as the control group. This suggests that the eye pain experienced by ME/CFS patients may come from causes beyond just dry eyes.

Pain and Sensitization

Naturally acquired adaptive immunity to Streptococcus pneumoniae is impaired in rheumatoid arthritis patients.

Ercoli, Giuseppe, Selway-Clarke, Hugh, Truijen, Dena et al.·Clinical & translational immunology·2024

This study compared how well people with rheumatoid arthritis (RA) and ME/CFS patients can fight off a common bacterial infection called Streptococcus pneumoniae. Researchers found that RA patients had weaker immune responses to this bacteria compared to ME/CFS patients, which may explain why RA patients get pneumonia more often. The study also looked at how a common RA treatment (rituximab, which depletes B cells) affected these immune responses.

Immune System

E2 ModerateBehavioralPEM not requiredCross-Sectional

Factors associated with having previously received a diagnosis of fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome: A cross sectional DanFunD study.

Tattan, Mais, Ørnbøl, Eva, Wellnitz, Kaare Bro et al.·Journal of psychosomatic research·2024

This study looked at 1,704 people with symptoms of functional somatic disorders (including ME/CFS, fibromyalgia, and irritable bowel syndrome) to understand who had received a diagnosis from a doctor. The researchers found that people—especially women—who had poor quality of life and negative beliefs about their illness were more likely to have received an official diagnosis. The study suggests that factors beyond just having symptoms affect whether people get diagnosed with these conditions.

Illness presentation and quality of life in myalgic encephalomyelitis/chronic fatigue syndrome and post COVID-19 condition: a pilot Australian cross-sectional study.

Weigel, Breanna, Eaton-Fitch, Natalie, Thapaliya, Kiran et al.·Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation·2024

This study compared symptoms and quality of life in people with ME/CFS, people with long COVID, and healthy controls in Australia. Both ME/CFS and long COVID patients experienced similar debilitating symptoms affecting memory, sleep, and physical function, and both groups had much lower quality of life scores than healthy people. The findings suggest that ME/CFS and long COVID are similarly serious illnesses that require comprehensive medical care.

Longitudinal Progression of Patients with Long COVID Treated in a Post-COVID Clinic: A Cross-Sectional Survey.

Hurt, Ryan T, Yadav, Siddhant, Schroeder, Darrell R et al.·Journal of primary care & community health·2024

This study surveyed over 500 Long COVID patients who received care at a specialized clinic about 2 years after their initial infection. While most patients reported that their symptoms improved compared to their first visit, only 4.5% felt they had fully recovered. Some treatments like low-dose naltrexone, vagal nerve stimulation, and fisetin were rated as helpful by a majority of patients who tried them.

Interventions

E2 ModerateCohortPEM unclearObservational

Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Rohrhofer, Johanna, Hauser, Lisa, Lettenmaier, Lisa et al.·Journal of clinical medicine·2024

This study found that ME/CFS patients have different types of immune system problems. Researchers divided patients into two groups: those with weakened immune systems and those with normal immune systems. The two groups showed different patterns of illness—one group had low levels of a protective immune protein, while the other group had signs that their gut barrier was leaking. This suggests that ME/CFS may not be one disease but rather multiple conditions that need different treatment approaches.

Immune System

Compelled loneliness and necessitated social isolation: "It's like being on the other side of a mirror, just looking in".

Wotherspoon, Natalie·Sociology of health & illness·2024

This study explored loneliness in people with ME/CFS by listening to 42 patients' experiences. The researchers found that loneliness in ME isn't just about being alone—it happens because ME symptoms keep people isolated AND because others often don't believe the illness is real, leading to rejection. As ME gets worse, people can get caught in a cycle where isolation and loneliness feed each other, making both worse over time.

E2 ModerateBehavioralPEM not requiredLongitudinal

Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study.

Van Oudenhove, Lukas, Debyser, Soetkin, Vergaelen, Elfi et al.·Journal of psychosomatic research·2024

This study followed 297 people with ME/CFS who received cognitive behavioral therapy (CBT) to see how their fatigue improved over time. Researchers found that people responded very differently to treatment: some improved significantly, some improved a little, and some didn't improve at all. People who started treatment with higher anxiety, depression, stress, and physical symptoms—and lower mood—were less likely to benefit from CBT.

Interventions

E2 ModerateCohortPEM unclearObservational

Low-dose Naltrexone Improves post-COVID-19 condition Symptoms.

Tamariz, Leonardo, Bast, Elizabeth, Klimas, Nancy et al.·Clinical therapeutics·2024

This study looked at whether treatments used for ME/CFS could help people with long COVID. Researchers reviewed records from 108 patients who tried different treatments including low-dose naltrexone, amitriptyline, duloxetine, and physical therapy. They found that patients taking low-dose naltrexone were about 5 times more likely to improve compared to those doing physical therapy alone, with improvements in both fatigue and pain.

Pain and SensitizationCognitive Impairment

Classification Accuracy and Description of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in an Integrated Health Care System, 2006-2017.

Liles, Elizabeth G, Irving, Stephanie A, Koppolu, Padma et al.·The Permanente journal·2024

This study looked at how often ME/CFS is diagnosed in a large health care system by checking electronic medical records from 2006 to 2017. Researchers found that while doctors used ME/CFS diagnosis codes for over 500 patients, only about 34% of the cases they reviewed actually matched the real diagnostic criteria for ME/CFS. This shows that relying only on diagnosis codes in medical records can give an inaccurate picture of how many people truly have ME/CFS.