ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

1–20 of 73 studies

E0 ConsensusReviewPEM unclearReview-Narrative

Therapeutic plasma exchange and immunomodulatory strategies in post-infectious syndromes: A review of immune dysregulation in PTLDS, long COVID, ME/CFS, and PANS/PANDAS.

Kaplan, Gary·Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis·2026

This review examines whether immune system abnormalities in ME/CFS, long COVID, and related post-infectious conditions might respond to immune-modifying treatments such as plasma exchange and immunoglobulin therapy. The authors report that while some patients with specific immune markers showed improvements in observational studies, two large controlled trials (RituxME in ME/CFS and a TPE trial in long COVID) did not demonstrate benefit in unselected patient groups, suggesting that better ways to identify which patients might benefit are needed.

BiomarkersInterventionsSleepImmune System

E0 ConsensusReviewPEM unclearSystematic-Review

Biomarkers of post-acute infection syndrome: a systematic literature review.

Wendt, Katharina, Schieck, Maximilian, Gille, Christian et al.·Frontiers in immunology·2026

This systematic review examined laboratory findings and molecular markers across 142 studies of post-acute infection syndromes, including post-COVID and ME/CFS. Researchers observed that energy metabolism, immune signalling, and gut bacteria appear to be altered in these conditions, with a central control pathway called NF-κB potentially linking many of these changes. However, the studies reviewed used very different methods and tested different molecules, so no single marker has yet been confirmed as reliable for diagnosis or treatment.

BiomarkersGut MicrobiomeEnergy MetabolismImmune System

E0 ConsensusReviewPEM unclearSystematic-Review

A systematic scoping review and conceptual analysis of new-onset fibromyalgia manifestations after non-hospitalized COVID-19: empirics, definitions, methodologies, pathophysiology, mapping of literature, and knowledge gaps.

Plaut, Shiloh·Journal of translational medicine·2026

This systematic review examined published studies on fibromyalgia-like symptoms that develop after mild COVID-19 infection. Researchers searched medical databases and found 228 studies reporting overlap between long COVID, chronic fatigue, and fibromyalgia, but noted that different studies use inconsistent definitions and methods, making it difficult to draw firm conclusions. The causes of these overlapping conditions remain unclear.

NeuroinflammationPain and SensitizationImmune SystemLong COVID Overlap

E0 ConsensusReviewPEM unclearReview-Narrative

Dynamic microclot profiling: thromboelastography advances precision management in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.

Saleem, Shafaq, Hussain, Ahmad, Haroon, Muhammad et al.·Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis·2026

This review examined whether a blood test called thromboelastography (TEG) could help diagnose and manage long COVID and ME/CFS by detecting microclots—tiny blood clots thought to persist in these conditions. Studies included in the review reported that microclots are commonly observed in both conditions, and that TEG shows patterns suggestive of altered blood clotting in long COVID patients. However, the review notes that TEG is not yet standardized across laboratories, and treatments targeting microclots (such as certain anticoagulants) still require further testing.

BiomarkersDiagnosticsLong COVID Overlap

E0 ConsensusReviewPEM not requiredMeta-Analysis

Risks of autoimmune and inflammatory post-acute COVID-19 conditions: a network cohort study in six European countries, the USA and Korea.

Burkard, Theresa Ms, López-Güell, Kim, Català, Martí et al.·BMJ public health·2026

This large study looked at whether people who had COVID-19 were more likely to develop autoimmune or inflammatory conditions—including ME/CFS and POTS—in the 9 months after infection. Researchers examined health records from over 2.5 million people across eight countries and did not observe increased rates of these conditions in COVID-19 patients compared to people who tested negative. However, the findings do not yet tell us whether similar patterns apply to ME/CFS specifically, and the study was observational rather than experimental.

Autonomic Nervous SystemImmune SystemLong COVID Overlap

E0 ConsensusReviewPEM unclearReview-Narrative

DNA methylation: unifying framework for complex chronic conditions.

Sharma, Sayan, Rodger, Euan J, Chatterjee, Aniruddha et al.·Trends in genetics : TIG·2026

This review examines how chemical tags on DNA (called DNA methylation) may help explain why ME/CFS, long COVID, fibromyalgia, and hypermobile Ehlers-Danlos syndrome share similar symptoms. The authors propose that studying these chemical changes across these related conditions could improve diagnosis and treatment. However, this is a framework paper synthesising existing evidence, not a new study proving how methylation causes these illnesses.

Pain and SensitizationBiomarkersDiagnosticsLong COVID Overlap

E0 ConsensusReviewPEM unclearReview-Narrative

[Post-COVID: An inventory focusing on the key complaints PEM and POTS].

Hensel, Ole, Pfrommer, Laura, Furch, Peggy et al.·MMW Fortschritte der Medizin·2026

This is a narrative review (a summary of existing research rather than a new study) that examined long-term effects of COVID-19, with a focus on post-exertional malaise (PEM) and postural tachycardia syndrome (POTS). The authors report that in people with post-COVID, PEM—a worsening of symptoms after exertion—was observed in approximately 86% of patients, and POTS-related symptoms in up to 82%. The review suggests pacing and symptom-focused treatments may help, though these are early findings from a narrative synthesis rather than definitive evidence.

InterventionsAutonomic Nervous SystemDiagnosticsLong COVID Overlap

E0 ConsensusReviewPEM not requiredReview-Narrative

Long COVID: lights and shadows on the clinical characterization of this emerging pathology.

Cogliandro, Viola, Bonfanti, Paolo·The new microbiologica·2024

This review examined Long COVID, a condition affecting 10-20% of people who had COVID-19 infection. Long COVID causes multiple symptoms across different body systems that significantly reduce quality of life. The review highlights that some Long COVID patients develop conditions like POTS (a heart rhythm problem when standing), ME/CFS (severe fatigue and post-exertional symptoms), and brain fog, and summarizes what treatments might help.

Long COVID OverlapPost-Exertional Malaise

E0 ConsensusReviewPEM unclearReview-Narrative

Navigating the Spectrum of Two Pediatric COVID-19 Complications: Multi-System Inflammatory Syndrome in Children and Post-Acute Sequelae of SARS-CoV-2 Infection.

Parzen-Johnson, Simon, Katz, Ben Z·Journal of clinical medicine·2024

This review article examines two serious complications that can occur in children after COVID-19 infection: MIS-C (a condition where the immune system overreacts and inflames multiple body systems) and PASC (long-term symptoms that persist after the acute infection ends). The authors found that while most children don't get severely ill from COVID-19 itself, these post-infection complications cause significant ongoing health problems. The review identifies important gaps in our understanding of why these conditions develop and calls for more research and resources to help affected children.

Long COVID Overlap

E0 ConsensusReviewPEM unclear

Blood virome research in myalgic encephalomyelitis/chronic fatigue syndrome: challenges and opportunities.

Obraitis, Dominic, Li, Dawei·Current opinion in virology·2024

This review examines whether viruses trigger myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Scientists have found that some ME/CFS cases may start after viral infections, and blood tests can detect viral genetic material in patients. The review highlights that while viruses are a suspected cause, no single virus has been found in all ME/CFS patients, and researchers need better tools to understand these complex viral patterns.

Long COVID Overlap

E0 ConsensusReviewPEM unclearEvidence-Map

ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature

Anthony L. Komaroff, W. Ian Lipkin·Frontiers in Medicine·2023

Harvard and Columbia researchers conducted a comprehensive review of biological abnormalities in ME/CFS and Long COVID. They found striking overlaps in immune dysregulation, autonomic dysfunction, metabolic disruption, and neurological features. The paper maps the literature to guide researchers working across both conditions.

Immune SystemLong COVID Overlap

E0 ConsensusReviewPEM unclearReview-Narrative

Persistent SARS-CoV-2 Infection, EBV, HHV-6 and Other Factors May Contribute to Inflammation and Autoimmunity in Long COVID.

Vojdani, Aristo, Vojdani, Elroy, Saidara, Evan et al.·Viruses·2023

This review examines how long COVID—a condition where symptoms persist months after a coronavirus infection—may develop through similar mechanisms to ME/CFS. The authors suggest that viral persistence, reactivation of old herpes viruses (like Epstein-Barr virus), immune system dysfunction, and gut microbiome changes may all contribute to ongoing inflammation and autoimmune problems. They propose testing for antibodies and other markers to better identify and treat long COVID.

Gut MicrobiomeImmune SystemLong COVID Overlap

E0 ConsensusReviewPEM unclearReview-Narrative

Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Grach, Stephanie L, Seltzer, Jaime, Chon, Tony Y et al.·Mayo Clinic proceedings·2023

This review explains how doctors can diagnose and manage ME/CFS, a serious illness that causes extreme tiredness and other symptoms, often starting after an infection. The authors note that ME/CFS shares many similarities with long COVID, the condition some people experience after having COVID-19. They provide practical guidance to help healthcare providers recognize and treat this condition.

Long COVID OverlapPost-Exertional Malaise

E0 ConsensusReviewPEM requiredReview-Narrative

Fatigue in Adults: Evaluation and Management.

Latimer, Kelly M, Gunther, Althea, Kopec, Michael·American family physician·2023

Fatigue is a very common reason people visit their doctors, and it can significantly impact daily life and work safety. This guideline explains that fatigue can come from different causes—normal tiredness that improves with rest and better habits, fatigue from other medical conditions, or chronic fatigue like ME/CFS. ME/CFS is a serious, long-lasting illness with no proven cure that causes a symptom called postexertional malaise, where activity makes symptoms worse, so patients need to carefully manage their energy levels.

Long COVID OverlapPost-Exertional Malaise

E0 ConsensusReviewPEM unclearSystematic-Review

Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)-A Systemic Review and Comparison of Clinical Presentation and Symptomatology.

Wong, Timothy L, Weitzer, Danielle J·Medicina (Kaunas, Lithuania)·2021

Researchers reviewed 21 studies about Long COVID (symptoms lasting months after COVID-19 infection) and compared them to ME/CFS symptoms. They found that Long COVID patients reported 25 out of 29 known ME/CFS symptoms, suggesting these two conditions share many similarities. The study highlights the need for better monitoring and treatment of patients with Long COVID, and calls for more standardized research methods to understand both conditions better.

Long COVID Overlap

E0 ConsensusReviewPEM not requiredSystematic-Review

The neurological symptoms of COVID-19: a systematic overview of systematic reviews, comparison with other neurological conditions and implications for healthcare services.

Wildwing, Tamar, Holt, Nicole·Therapeutic advances in chronic disease·2021

This study reviewed 45 existing research papers about neurological symptoms people experience with COVID-19. Researchers found that some COVID-19 patients develop long-lasting symptoms like fatigue and muscle pain that look very similar to ME/CFS and other neurological conditions. The authors suggest that doctors may need better training to recognize and treat these ongoing symptoms, and that healthcare services may need more resources to help patients.

Long COVID Overlap

E2 ModerateCohortPEM unclearCross-Sectional

Involvement of autoantibodies against G protein-coupled receptors in post-COVID condition and Chronic Fatigue Syndrome.

Azcue, N, Prada, A, Del Pino, R et al.·Scientific reports·2026

Researchers compared immune markers called autoantibodies in people with post-COVID condition, ME/CFS, and healthy controls. They found that people with ME/CFS had higher levels of antibodies against certain nerve receptors (β2 adrenergic), and these antibodies were associated with autonomic nervous system problems and memory changes. However, this is a single cross-sectional study, and autoimmunity remains one of several proposed mechanisms—it is not yet clear whether these antibodies are a cause or a consequence of ME/CFS.

BiomarkersAutonomic Nervous SystemImmune SystemCognitive Impairment

E2 ModerateCohortPEM unclearCross-Sectional

Plasma Extracellular Vesicle Surface Marker Profiling Reveals Immune Cell-Associated Mitochondrial Membrane Potential Alterations in Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Ikeda, Gentaro, Koike-Ieki, Mariko, Inoue, Hiroyuki et al.·Open forum infectious diseases·2026

Researchers analyzed tiny cell particles called extracellular vesicles in blood samples from people with Long COVID, ME/CFS, and healthy controls. They observed that both Long COVID and ME/CFS groups had elevated levels of certain immune cell-derived particles and alterations in mitochondrial (energy-producing) markers within B cells and other immune cells, though the findings were not identical between groups. These preliminary results suggest there may be shared immune and metabolic changes in these conditions, but the meaning of these changes for patient health remains unclear and needs further study.

BiomarkersEnergy MetabolismImmune SystemLong COVID Overlap

E2 ModeratePEM unclearRegistry-Resource

Risk factors for severe post-COVID condition in children, adolescents, and young adults.

Donath, Quirin, Haegele, Matthias, Schindler, Daniela et al.·European journal of pediatrics·2026

This observational study from a German pediatric hospital followed 120 children and young adults with post-COVID condition (PCC), observing that those with more severe illness were more likely to have had 12 or more symptoms during their initial COVID-19 infection, alongside other acute symptoms such as trouble concentrating and fainting-like episodes. One quarter of participants met criteria for ME/CFS, and all of these were in the severely affected group; by analogy, if similar patterns apply to ME/CFS patients, early identification of high-symptom-burden acute illness might help predict who develops severe long-term illness. These findings are preliminary and come from a single hospital site.

Severe MEAutonomic Nervous SystemDiagnosticsCognitive Impairment

E2 ModerateCohortPEM unclearCross-Sectional

Central noradrenergic deficiency in post-infectious chronic fatigue: neurobehavioral correlates.

Aregawi, Lillian, Walitt, Brian, Sullivan, Patti et al.·Brain communications·2026

Researchers measured levels of norepinephrine (a brain chemical) in cerebrospinal fluid from people with ME/CFS, Long COVID, and Parkinson's disease, comparing them to healthy volunteers. They observed that norepinephrine pathway activity was lower in all three patient groups, and in Long COVID patients with post-exertional malaise, this reduction was particularly pronounced. This is one study in a small sample, and it remains unclear whether these findings fully explain fatigue and brain fog or apply directly to ME/CFS.

BiomarkersCognitive ImpairmentLong COVID OverlapPost-Exertional Malaise

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Evidence browser

Therapeutic plasma exchange and immunomodulatory strategies in post-infectious syndromes: A review of immune dysregulation in PTLDS, long COVID, ME/CFS, and PANS/PANDAS.

Biomarkers of post-acute infection syndrome: a systematic literature review.

A systematic scoping review and conceptual analysis of new-onset fibromyalgia manifestations after non-hospitalized COVID-19: empirics, definitions, methodologies, pathophysiology, mapping of literature, and knowledge gaps.

Dynamic microclot profiling: thromboelastography advances precision management in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.

Risks of autoimmune and inflammatory post-acute COVID-19 conditions: a network cohort study in six European countries, the USA and Korea.

DNA methylation: unifying framework for complex chronic conditions.

[Post-COVID: An inventory focusing on the key complaints PEM and POTS].

Long COVID: lights and shadows on the clinical characterization of this emerging pathology.

Navigating the Spectrum of Two Pediatric COVID-19 Complications: Multi-System Inflammatory Syndrome in Children and Post-Acute Sequelae of SARS-CoV-2 Infection.

Blood virome research in myalgic encephalomyelitis/chronic fatigue syndrome: challenges and opportunities.

ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature

Persistent SARS-CoV-2 Infection, EBV, HHV-6 and Other Factors May Contribute to Inflammation and Autoimmunity in Long COVID.

Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Fatigue in Adults: Evaluation and Management.

Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)-A Systemic Review and Comparison of Clinical Presentation and Symptomatology.

The neurological symptoms of COVID-19: a systematic overview of systematic reviews, comparison with other neurological conditions and implications for healthcare services.

Involvement of autoantibodies against G protein-coupled receptors in post-COVID condition and Chronic Fatigue Syndrome.

Plasma Extracellular Vesicle Surface Marker Profiling Reveals Immune Cell-Associated Mitochondrial Membrane Potential Alterations in Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Risk factors for severe post-COVID condition in children, adolescents, and young adults.

Central noradrenergic deficiency in post-infectious chronic fatigue: neurobehavioral correlates.

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