Evidence browser

Chronic post-COVID-19 syndrome and chronic fatigue syndrome: Is there a role for extracorporeal apheresis?

Bornstein, Stefan R, Voit-Bak, Karin, Donate, Timo et al.·Molecular psychiatry·2022

Some people who had COVID-19 continue to experience fatigue and breathing problems long after recovering from the infection, a condition called long-COVID. This pattern of ongoing symptoms looks similar to ME/CFS, another condition that causes persistent fatigue. Researchers found that both conditions may involve the body producing antibodies (immune proteins) that attack certain nerve receptors. A treatment called extracorporeal apheresis, which filters blood to remove these harmful antibodies, showed promise in improving symptoms in ME/CFS patients and might also help those with long-COVID.

NeuroinflammationImmune System

Aberrations in the Cross-Talks Among Redox, Nuclear Factor-κB, and Wnt/β-Catenin Pathway Signaling Underpin Myalgic Encephalomyelitis and Chronic Fatigue Syndrome.

Maes, Michael, Kubera, Marta, Kotańska, Magdalena·Frontiers in psychiatry·2022

This study examined proteins and metabolites in ME/CFS patients to understand how the disease works at a molecular level. Researchers found that ME/CFS involves problems with three interconnected cellular systems: how cells handle harmful oxidative stress, how the immune system responds through inflammation, and how cells communicate through a pathway called Wnt/β-catenin. The study suggests ME/CFS may be triggered by various causes—like infections or toxic exposures—but they all damage these same three systems.

E3 PreliminaryMechanismPEM not requiredCross-Sectional

No Signs of Neuroinflammation in Women With Chronic Fatigue Syndrome or Q Fever Fatigue Syndrome Using the TSPO Ligand [11C]-PK11195.

Raijmakers, Ruud, Roerink, Megan, Keijmel, Stephan et al.·Neurology(R) neuroimmunology & neuroinflammation·2022

Researchers used a specialized brain scan to look for signs of inflammation in the brains of women with ME/CFS and Q fever fatigue syndrome, compared to healthy women. The scan didn't find evidence of the type of brain inflammation they were looking for, which contradicts some earlier research suggesting inflammation might play a role in these conditions.

NeuroinflammationBiomarkersImmune System

E3 PreliminaryBehavioralPEM unclear

‘The Lightning Process’ and chronic fatigue syndrome/myalgic encephalomyelitis.

Vallings, Rosamund·Journal of primary health care·2022

This study examines 'The Lightning Process,' a coaching program that some people claim can help with ME/CFS. The author, a doctor experienced in ME/CFS care, analyzed what is known about this approach and its effects on patients with this illness. The study raises concerns about whether the program is safe and effective for people with ME/CFS.

Interventions

E3 PreliminaryReviewPEM not requiredReview-Narrative

Autoimmune Autonomic Dysfunction Syndromes: Potential Involvement and Pathophysiology Related to Complex Regional Pain Syndrome, Fibromyalgia, Chronic Fatigue Syndrome, Silicone Breast Implant-Related Symptoms and Post-COVID Syndrome.

Mahroum, Naim, Shoenfeld, Yehuda·Pathophysiology : the official journal of the International Society for Pathophysiology·2022

This article suggests that several chronic conditions—including ME/CFS, fibromyalgia, long COVID, and complex regional pain syndrome—may share a common cause: the immune system mistakenly producing antibodies that attack the autonomic nervous system (the part of your body that controls automatic functions like heart rate and blood pressure). The authors propose calling these conditions "autoimmune autonomic dysfunction syndromes" to highlight this shared mechanism and potentially help doctors diagnose and treat them more effectively.

Autonomic Nervous System

[Stress, asthenia and cognitive disorders].

Vasenina, E E, Gankina, O A, Levin, O S·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·2022

This article examines how extreme tiredness (asthenia) relates to ME/CFS and other conditions affecting mood and thinking. The authors explain that severe fatigue can start as the body's warning signal that energy is running out, but it can develop into a serious, disabling disease on its own. They discuss how fatigue often occurs together with depression, anxiety, and problems with memory or concentration, which can make it harder for doctors to figure out what's really causing a patient's symptoms.

Cognitive Impairment

E3 PreliminaryReviewPEM requiredReview-Narrative

The Pathobiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: The Case for Neuroglial Failure.

Renz-Polster, Herbert, Tremblay, Marie-Eve, Bienzle, Dorothee et al.·Frontiers in cellular neuroscience·2022

This study suggests that ME/CFS might be caused by problems with certain support cells in the brain called glia, which help protect and maintain nerve cells. The researchers reviewed existing research on two key ME/CFS symptoms—feeling worse after activity and reduced blood flow to the brain—and found evidence that brain cell dysfunction could explain many of the different problems seen in ME/CFS.

NeuroinflammationPost-Exertional Malaise

NeuroinflammationImmune System

At the Root of 3 "Long" Diseases: Persistent Antigens Inflicting Chronic Damage on the Brain and Other Organs in Gulf War Illness, Long-COVID-19, and Chronic Fatigue Syndrome.

James, Lisa M, Georgopoulos, Apostolos P·Neuroscience insights·2022

This review explores why some people develop long-lasting illnesses after exposure to viruses or bacteria, while others recover normally. The researchers propose that certain infections may persist in the body longer in people with specific immune system markers (HLA types), potentially causing ongoing damage to the brain and other organs. They suggest this mechanism might explain symptoms seen in ME/CFS, long-COVID, and Gulf War Illness.

Impaired TRPM3-dependent calcium influx and restoration using Naltrexone in natural killer cells of myalgic encephalomyelitis/chronic fatigue syndrome patients.

Eaton-Fitch, Natalie, Du Preez, Stanley, Cabanas, Hélène et al.·Journal of translational medicine·2022

This study found that immune cells called natural killer cells in ME/CFS patients have a broken calcium channel (TRPM3) that prevents them from working properly. When researchers treated these cells overnight with a drug called naltrexone, the calcium channel started working better and the immune cells functioned more like those from healthy people. This suggests that ME/CFS may involve faulty ion channels and that naltrexone could potentially help restore immune cell function.

Molecular Hydrogen as a Medical Gas for the Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Possible Efficacy Based on a Literature Review.

Hirano, Shin-Ichi, Ichikawa, Yusuke, Sato, Bunpei et al.·Frontiers in neurology·2022

This review examines whether molecular hydrogen (H₂) gas might help treat ME/CFS by fixing problems in the energy-producing parts of cells. The researchers looked at existing studies showing that H₂ can reduce harmful molecules called free radicals and improve fatigue in animals and healthy people. While the idea is promising, the authors emphasize that more human studies are needed before H₂ can be recommended as a treatment.

Energy Metabolism

Bioinformatics and systems biology approach to identify the pathogenetic link of Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Lv, Yongbiao, Zhang, Tian, Cai, Junxiang et al.·Frontiers in immunology·2022

Researchers compared the genes involved in Long COVID (lasting symptoms after COVID-19 infection) and ME/CFS to see if they share common biological causes. They found 9 genes that appear in both conditions and identified five key proteins that may be driving the shared symptoms. The study suggests these conditions may have overlapping mechanisms, pointing toward potential new treatments worth testing in future research.

E3 PreliminaryCohortPEM unclearCase-Control

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

Orthostatic intolerance as a potential contributor to prolonged fatigue and inconsistent performance in elite swimmers.

Petracek, Lindsay S, Eastin, Ella F, Rowe, Ian R et al.·BMC sports science, medicine & rehabilitation·2022

This study looked at five elite swimmers who experienced severe fatigue and couldn't perform at their usual level. The researchers tested whether orthostatic intolerance—a condition where the body struggles to maintain proper blood pressure when standing—might explain their symptoms. When the swimmers were tested with standing or tilt table tests, they all felt fatigued and other symptoms appeared. After receiving treatment with extra salt and fluids, all five swimmers felt significantly better and returned to normal performance.

Autonomic Nervous System

E3 PreliminaryReviewPEM not requiredReview-Narrative

Stress, Asthenia, and Cognitive Disorders.

Vasenina, E E, Gankina, O A, Levin, O S·Neuroscience and behavioral physiology·2022

This article explores the connection between extreme tiredness (asthenia), chronic fatigue syndrome (ME/CFS), and problems with thinking and mood. The authors explain that fatigue can start as your body's way of protecting itself when energy is running low, but it can develop into a serious condition that affects quality of life. They discuss how ME/CFS often appears alongside cognitive difficulties and mood changes, which can make diagnosis confusing.

Cognitive Impairment

E3 PreliminaryMechanismPEM not requiredCross-Sectional

Neurochemical abnormalities in chronic fatigue syndrome: a pilot magnetic resonance spectroscopy study at 7 Tesla.

Godlewska, Beata R, Williams, Stephen, Emir, Uzay E et al.·Psychopharmacology·2022

Researchers used a powerful brain scanning technique to measure chemicals in the brains of people with ME/CFS and compared them to healthy people. They found that people with ME/CFS had lower levels of three important brain chemicals: glutathione (which helps protect against cell damage), creatine (which helps produce energy), and myo-inositol (which is important for brain cell function). These findings suggest that ME/CFS may involve problems with energy production and cell damage in the brain.

Energy Metabolism

E3 PreliminaryReviewPEM not requiredReview-Narrative

Skeletal muscle alterations in patients with acute Covid-19 and post-acute sequelae of Covid-19.

Soares, Madu N, Eggelbusch, Moritz, Naddaf, Elie et al.·Journal of cachexia, sarcopenia and muscle·2022

Many people with COVID-19 and long COVID experience muscle weakness and tiredness, especially after physical activity. This review examines what happens inside muscle cells in these patients, including muscle fiber shrinkage, changes in how muscles use energy, and immune cell buildup. The authors suggest that severe illness, lack of activity, low oxygen levels, and poor nutrition all contribute to these problems, similar to what happens in other serious conditions.

Post-Exertional Malaise

COVID-19 in the perioperative setting: A review of the literature and the clinical landscape.

O'Glasser, Avital Y, Schenning, Katie J·Perioperative care and operating room management·2022

This article reviews what doctors know about surgical risks for people who have had COVID-19. It discusses how hospitals have had to balance treating COVID-19 patients while also catching up on surgeries that were delayed during the pandemic. The authors highlight that COVID-19 survivors face higher risks during surgery and anesthesia, and they call for careful planning to keep these patients safe.

EBV/HHV-6A dUTPases contribute to myalgic encephalomyelitis/chronic fatigue syndrome pathophysiology by enhancing TFH cell differentiation and extrafollicular activities.

Cox, Brandon S, Alharshawi, Khaled, Mena-Palomo, Irene et al.·JCI insight·2022

This study found that some people with ME/CFS have abnormal immune responses linked to past infections with Epstein-Barr virus (EBV) and human herpesvirus 6A (HHV-6A). The researchers discovered that proteins from these viruses may trigger the immune system to produce excess amounts of certain signaling molecules, leading to confused immune cell behavior. This suggests a possible biological mechanism for how these common viruses might contribute to ME/CFS symptoms in some patients.