Evidence browser

Perspective: Drawing on Findings From Critical Illness to Explain Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Stanculescu, Dominic, Bergquist, Jonas·Frontiers in medicine·2022

This paper suggests that ME/CFS might develop through similar biological problems seen in people with severe critical illnesses. The researchers propose that four interconnected issues—reduced blood flow to tissues, damage to the gut lining, problems with pituitary gland function, and low thyroid hormone activity—could work together to create a cycle that keeps ME/CFS going. Understanding these connections could help develop better treatments.

Post-Exertional Malaise

NeuroinflammationImmune SystemPost-Exertional Malaise

Molecular Mechanisms of Neuroinflammation in ME/CFS and Long COVID to Sustain Disease and Promote Relapses.

Tate, Warren, Walker, Max, Sweetman, Eiren et al.·Frontiers in neurology·2022

This study explores why ME/CFS and Long COVID symptoms persist and come and go in cycles. The researchers propose that after an initial trigger—like a viral infection, chemical exposure, or major stress—inflammation spreads to the brain through damaged blood vessels, causing ongoing brain inflammation that keeps the illness cycling. They suggest that similar mechanisms may explain why both ME/CFS (from various causes) and Long COVID (from COVID-19) produce remarkably similar symptoms despite different starting triggers.

Commonalities in the Features of Cancer and Chronic Fatigue Syndrome (CFS): Evidence for Stress-Induced Phenotype Instability?

Rusin, Andrej, Seymour, Colin, Cocchetto, Alan et al.·International journal of molecular sciences·2022

This review compares ME/CFS with cancer-related fatigue, two conditions that share similar exhaustion symptoms. The authors examined research showing that both conditions may involve problems with stress hormones, immune system inflammation, energy production in cells, and genetic factors. They suggest these two different diseases might actually represent different points on a spectrum of how the body responds to stress, rather than being completely separate conditions.

E3 PreliminaryMechanismPEM unclearObservational

Late-Onset Hypogonadism in a Male Patient with Long COVID Diagnosed by Exclusion of ME/CFS.

Soejima, Yoshiaki, Otsuka, Yuki, Tokumasu, Kazuki et al.·Medicina (Kaunas, Lithuania)·2022

This case report describes a 36-year-old man who had persistent fatigue after COVID-19 infection. Doctors discovered he had abnormally low testosterone levels and pituitary gland problems, which can cause fatigue and other symptoms. After treatment with traditional herbal medicine, his fatigue improved along with his hormone levels and gland function.

Does Coenzyme Q10 Plus Selenium Supplementation Ameliorate Clinical Outcomes by Modulating Oxidative Stress and Inflammation in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?

Castro-Marrero, Jesús, Domingo, Joan Carles, Cordobilla, Begoña et al.·Antioxidants & redox signaling·2022

This study tested whether taking Coenzyme Q10 and selenium supplements together could help ME/CFS patients feel better. Twenty-seven patients took these supplements daily for 8 weeks, and researchers measured their fatigue, quality of life, sleep, and blood markers related to stress and inflammation. The supplements improved overall fatigue and quality of life, and blood tests showed reduced oxidative stress and inflammation, though sleep did not improve.

E3 PreliminaryCohortPEM unclearCase-Control

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: First Described Complication after Gam-COVID-Vac Vaccine.

Manysheva, Ksenia, Sherman, Mikhail, Zhukova, Natalia et al.·Psychiatria Danubina·2022

This report describes one case of a 25-year-old woman who developed ME/CFS symptoms about 10 days after receiving the Sputnik V COVID-19 vaccine. She experienced severe fatigue, muscle pain, and difficulty moving. This is the first documented case linking ME/CFS to this particular vaccine, though it remains unclear whether the vaccine caused the condition or if it occurred by coincidence.

Immune SystemPost-Exertional Malaise

E3 PreliminaryMechanismPEM not requiredMechanistic

[Effect of herbal cake-separated moxibustion on behavioral stress reactions and blood lactic acid level and muscular AMPK/PGC-1α signaling in rats with chronic fatigue syndrome].

Xu, Xiao-Shan, Ma, Wei, Xiong, Luo-Jie et al.·Zhen ci yan jiu = Acupuncture research·2022

Researchers tested a traditional Chinese medicine treatment called herbal cake-separated moxibustion on rats with chronic fatigue syndrome to see if it could improve fatigue and stress responses. The treatment appeared to reduce physical exhaustion markers in the blood (lactic acid) and activate cellular energy-producing pathways in muscles, similar to effects seen with oral herbal medicine.

Role of Creatine Supplementation in Conditions Involving Mitochondrial Dysfunction: A Narrative Review.

Marshall, Robert Percy, Droste, Jan-Niklas, Giessing, Jürgen et al.·Nutrients·2022

This review examines whether creatine supplements—commonly used by athletes to boost performance—might also help people with diseases involving mitochondrial problems (the energy-producing parts of cells). Creatine appears to have several beneficial effects, including improving energy production, reducing harmful oxidative stress, and protecting nerve cells. While early evidence suggests creatine could be helpful for conditions where mitochondria aren't working well, more rigorous clinical trials are needed before doctors can recommend it as a standard treatment.

E3 PreliminaryBehavioralPEM not requiredObservational

Psychological counselling in patients with a peripheral facial palsy: initial experience from an expert centre.

Siemann, Ietske, Sanches, Elijah E, de Jongh, Frank W et al.·Journal of plastic, reconstructive & aesthetic surgery : JPRAS·2022

This study looked at how psychological counselling helps people with peripheral facial palsy (a condition causing sudden facial weakness). Researchers found that about two-thirds of patients had symptoms of anxiety or depression related to their condition. The study shows that talking to a psychologist as part of care can help patients cope better with their illness and make decisions about treatment.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Understanding Long Covid: Nosology, social attitudes and stigma.

Byrne, Eleanor Alexandra·Brain, behavior, and immunity·2022

This article discusses how Long Covid patients face stigma and discrimination similar to what ME/CFS patients have experienced for decades. The author argues that refusing to acknowledge these similarities actually reinforces stigma against both conditions. The piece emphasizes that these attitudes can harm patients by limiting how they're able to describe and understand their own illness experiences.

Recovering from chronic fatigue syndrome as an intra-active process.

Groven, Karen Synne, Dahl-Michelsen, Tone·Health care for women international·2022

This study examined the story of one woman who recovered from ME/CFS to understand how healing from this illness happens. Instead of debating whether ME/CFS is 'purely physical' or 'purely psychological,' the researchers looked at how many different factors—including both biological and non-biological elements—worked together in her recovery. The study suggests that recovery involves the interaction of many different things in a person's life, not just one single cause.

E3 PreliminaryMechanismPEM not requiredMechanistic

Mental fatigue does not substantially alter neuromuscular function in young, healthy males and females.

Kowalski, Katie L, Tierney, Bernadette C, Christie, Anita D·Physiology & behavior·2022

This study tested whether mental fatigue—the tiredness you feel after focusing hard on a task—changes how your muscles work. Thirty healthy young adults completed a difficult attention task or watched a documentary, and researchers measured their muscle function before and after. The study found that both men and women showed some small changes in muscle performance, but these same changes also happened in the control group, suggesting mental fatigue alone probably doesn't significantly affect how muscles function in healthy people.

E3 PreliminaryPEM unclear

Myalgic encephalomyelitis/chronic fatigue syndrome post coronavirus disease 2019.

Kusama, Yoshiki, Fukui, Sadahiro, Maruyama, Makiko et al.·Pediatrics international : official journal of the Japan Pediatric Society·2022

This study examines whether ME/CFS can develop in children after they have COVID-19. The researchers reviewed existing information about how post-COVID conditions might lead to ME/CFS symptoms in young patients. This is important because understanding the link between COVID-19 and ME/CFS could help doctors recognize and support children who develop this condition after a viral infection.

Long COVID Overlap

E3 PreliminaryGuidelinePEM unclearGuideline

Postacute Sequelae of SARS-CoV-2 Infection-Lessons Learned From a Coordinated Health System Response.

Ganesh, Ravindra, Vanichkachorn, Greg S, Munipalli, Bala et al.·Mayo Clinic proceedings. Innovations, quality & outcomes·2022

This study describes how Mayo Clinic, a large healthcare system across five states, created a coordinated plan to help patients recover from long-term COVID-19 symptoms. Doctors from many different specialties worked together to develop consistent guidelines for evaluating and treating these patients. The system includes specialized appointment forms, sample collection for research, and dedicated treatment programs to provide better care.

Long COVID Overlap

E3 PreliminaryMechanismPEM unclearCross-Sectional

The Occurrence of Hyperactivated Platelets and Fibrinaloid Microclots in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Nunes, Jean M, Kruger, Arneaux, Proal, Amy et al.·Pharmaceuticals (Basel, Switzerland)·2022

This study found that people with ME/CFS have blood clotting abnormalities similar to those seen in Long COVID. Researchers discovered that ME/CFS patients have overactive platelets (blood cells involved in clotting) and tiny clots made of a protein called fibrin scattered throughout their blood plasma. These microscopic clots may block small blood vessels and reduce oxygen delivery to tissues, potentially explaining fatigue and other ME/CFS symptoms.

Mitochondria as the Essence of Yang Qi in the Human Body.

Luo, Junjie, Shen, Shiwei, Xia, Jingjing et al.·Phenomics (Cham, Switzerland)·2022

This article explores whether the ancient Chinese medicine concept of 'Yang Qi' (vital energy) maps onto modern understanding of mitochondria—the energy-producing structures in our cells. The authors argue that both concepts describe something essential to human health and that weakness in either leads to illness, including chronic fatigue syndrome, poor sleep, cognitive decline, and metabolic problems.

E3 PreliminaryMechanismPEM not requiredMechanistic

Assessment of Hearing and Vestibular Functions in a Post-COVID-19 Patient: A Clinical Case Study.

Andreeva, Irina Germanovna, Gvozdeva, Alisa, Pimenova, Vera et al.·Diagnostics (Basel, Switzerland)·2022

This study examined one patient who had both long COVID and chronic fatigue syndrome. Doctors tested their hearing and balance systems, and found problems with how the brain processes sounds—particularly difficulty with rapid sound changes and understanding speech. Interestingly, the nerve fibers in the skin and eyes were normal, suggesting the problem is in how the brain handles auditory information rather than in damaged nerves. The researchers suggest that this auditory processing difficulty may add extra strain to the nervous system and worsen fatigue during daily activities.

Cognitive Impairment

Differential Impacts of HHV-6A versus HHV-6B Infection in Differentiated Human Neural Stem Cells.

Bahramian, Elham, Furr, Mercede, Wu, Jerry T et al.·Frontiers in immunology·2022

This study examined how two closely related viruses called HHV-6A and HHV-6B infect different types of nerve cells in the brain. Researchers found that both viruses can infect certain brain cells that use glutamate and dopamine (chemical messengers), but neither virus infected a third type of brain cell that uses GABA. Importantly, HHV-6A appeared to cause more damage to infected cells than HHV-6B, suggesting it may be more harmful to nerve tissue.

Neuroinflammation

Renal abscess with Capnocytophaga canimorsus infection from a dog bite.

Trainor-Moss, Santiago, Acquah, Rebecca Ruth, Peirse, Mary et al.·BMJ case reports·2022

This report describes one patient who developed a serious kidney infection caused by bacteria from a dog bite. After treatment with antibiotics, the patient recovered from the acute infection but then developed lasting fatigue symptoms similar to ME/CFS that persisted after the infection cleared.