E0ReviewPEM ?
[Post-COVID: An inventory focusing on the key complaints PEM and POTS].
2026Hensel, Ole et al.·MMW Fortschritte der Medizin·Review-Narrative
← Research Hub
ImmunologyPEM-relevant
Long COVID Overlap
58 studies in the atlas
Long COVID — also called post-acute sequelae of SARS-CoV-2 (PASC) — shares substantial clinical overlap with ME/CFS, including post-exertional malaise, fatigue, cognitive impairment, and autonomic abnormalities such as orthostatic intolerance. A subset of Long COVID patients meet formal diagnostic criteria for ME/CFS. Research explores shared mechanisms including immune-system abnormalities, viral persistence, microbiome disruption, and autonomic nervous system impairment. These mechanisms remain under investigation and are not fully settled. Understanding this overlap has strengthened the case for the broader category of post-infectious illness and brought new research attention to mechanisms that have been studied in ME/CFS for decades.
What we know
- Studies suggest a significant proportion of Long COVID patients with persistent symptoms meet ME/CFS diagnostic criteria, though estimates vary widely depending on methodology and cohort
- PEM has been reported in many Long COVID patients, particularly those with longer symptom duration
- Overlapping patterns of immune-system abnormalities have been observed in comparative studies
- The COVID-19 pandemic has substantially increased research attention and funding for post-infectious conditions, including ME/CFS
What remains uncertain
- Long COVID-triggered ME/CFS may share mechanisms with other post-infectious forms, but SARS-CoV-2 viral persistence could introduce distinct features
- Autoimmune processes may differ between Long COVID and classic ME/CFS, though evidence is preliminary
- Some Long COVID patients appear to recover over 1–2 years, while ME/CFS recovery is generally rarer — the reasons for this difference are not understood
- Research advances in Long COVID may benefit the broader ME/CFS field, and vice versa
What is emerging
- Whether treatments developed for Long COVID will prove effective for ME/CFS patients
- How to distinguish early Long COVID from Long COVID that will develop into ME/CFS
- The long-term prevalence of ME/CFS in post-COVID populations
- Whether ME/CFS diagnostic criteria need adaptation for post-COVID presentations
- Whether the overlapping features reflect shared pathophysiology or convergent symptoms from different causes
Start here
E0 ConsensusPEM 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.
Research Momentum
46 publications over 6 years. Recent trend: steady (7/year over the last 3 years).
Top Studies
58 of 58, sorted by evidence level and year
E0ReviewPEM ?
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.
2026Plaut, Shiloh·Journal of translational medicine·Systematic-Review
E0ReviewPEM ✗
Long COVID: lights and shadows on the clinical characterization of this emerging pathology.
2024Cogliandro, Viola et al.·The new microbiologica·Review-Narrative
E0ReviewPEM ?
Blood virome research in myalgic encephalomyelitis/chronic fatigue syndrome: challenges and opportunities.
2024Obraitis, Dominic et al.·Current opinion in virology
E0ReviewPEM ?
ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature
2023Anthony L. Komaroff et al.·Frontiers in Medicine·Evidence-Map
E0ReviewPEM ?
Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
2023Grach, Stephanie L et al.·Mayo Clinic proceedings·Review-Narrative
E0ReviewPEM ?
Persistent SARS-CoV-2 Infection, EBV, HHV-6 and Other Factors May Contribute to Inflammation and Autoimmunity in Long COVID.
2023Vojdani, Aristo et al.·Viruses·Review-Narrative
E0ReviewPEM ✓
Fatigue in Adults: Evaluation and Management.
2023Latimer, Kelly M et al.·American family physician·Review-Narrative
E0ReviewPEM ?
Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)-A Systemic Review and Comparison of Clinical Presentation and Symptomatology.
2021Wong, Timothy L et al.·Medicina (Kaunas, Lithuania)·Systematic-Review
E0ReviewPEM ✗
The neurological symptoms of COVID-19: a systematic overview of systematic reviews, comparison with other neurological conditions and implications for healthcare services.
2021Wildwing, Tamar et al.·Therapeutic advances in chronic disease·Systematic-Review
E0ReviewPEM ?
Navigating the Spectrum of Two Pediatric COVID-19 Complications: Multi-System Inflammatory Syndrome in Children and Post-Acute Sequelae of SARS-CoV-2 Infection.
2024Parzen-Johnson, Simon et al.·Journal of clinical medicine·Review-Narrative
E2CohortPEM ✗
Persistent fatigue in long-COVID is not associated with peripheral inflammatory or cellular stress biomarkers: A cross-sectional controlled study.
2026Omdal, Roald et al.·Brain, behavior, & immunity - health·Cross-Sectional
E2CohortPEM ✗
Subclinical Hypercoagulable Viscoelastic Characteristics Associated with Post-Acute Sequelae of SARS-CoV2 Physical Symptoms in COVID-19 ALI/ARDS Survivors.
2026Jones, Ansley E et al.·Journal of intensive care medicine·Cross-Sectional
E2CohortPEM ?
Elevated risk of new-onset chronic fatigue syndrome/myalgic encephalomyelitis up to four years after SARS-CoV-2 infection.
2025Hadidchi, Roham et al.·Journal of translational medicine·Observational
E2CohortPEM ✗
Unmasking the Long-Term Effects of COVID-19 With a Focus on Chronic Fatigue Syndrome: A Community-Based Study From India.
2025Gupta, Arti et al.·Cureus·Cross-Sectional
E2CohortPEM ✗
Risk of chronic fatigue syndrome after COVID-19: A retrospective cohort study of 3227281 patients.
2024Chen, Chih-Wei et al.·Journal of infection and public health·Observational
E2CohortPEM ✗
Long-Term Impairment of Working Ability in Subjects under 60 Years of Age Hospitalised for COVID-19 at 2 Years of Follow-Up: A Cross-Sectional Study.
2024Frallonardo, Luisa et al.·Viruses·Cross-Sectional
E2CohortPEM ✗
Three-Month Symptom Profiles Among Symptomatic Adults With Positive and Negative Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Prospective Cohort Study From the INSPIRE Group.
2023Spatz, Erica S et al.·Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·Longitudinal
E2CohortPEM ✗
Lowered oxygen saturation and increased body temperature in acute COVID-19 largely predict chronic fatigue syndrome and affective symptoms due to Long COVID: A precision nomothetic approach.
2023Al-Hadrawi, Dhurgham Shihab et al.·Acta neuropsychiatrica·Cross-Sectional
E2CohortPEM ?
Fatigue presentation, severity, and related outcomes in a prospective cohort following post-COVID-19 hospitalization in British Columbia, Canada.
2023Magel, Tianna et al.·Frontiers in medicine·Longitudinal
E2CohortPEM ✗
Predictors of Long COVID in Patients without Comorbidities: Data from the Polish Long-COVID Cardiovascular (PoLoCOV-CVD) Study.
2022Chudzik, Michał et al.·Journal of clinical medicine·Observational
E2CohortPEM ?
Chronic fatigue syndrome: an emerging sequela in COVID-19 survivors?
2021Mantovani, Elisa et al.·Journal of neurovirology·Cross-Sectional
E2BehavioralPEM ✗
Prevalence and correlates of chronic fatigue syndrome and post-traumatic stress disorder after the outbreak of the COVID-19.
2021Simani, Leila et al.·Journal of neurovirology·Cross-Sectional
E2CohortPEM ?
Facility-Measured Sleep Electroencephalographic Microstructures in Long COVID.
2026Sun, Haoqi et al.·Sleep·Observational
E2CohortPEM ?
Cardiopulmonary Exercise Testing Reveals Functional Limitations and Work Disability in Severe Post-COVID-19 and ME/CFS Patients.
2026Tomaskovic, Aleksandar et al.·Sports medicine - open·Cross-Sectional
E2PEM ?
Risk factors for severe post-COVID condition in children, adolescents, and young adults.
2026Donath, Quirin et al.·European journal of pediatrics·Registry-Resource
E2CohortPEM ?
Involvement of autoantibodies against G protein-coupled receptors in post-COVID condition and Chronic Fatigue Syndrome.
2026Azcue, N et al.·Scientific reports·Cross-Sectional
E2CohortPEM ✗
Post-Exertional Malaise in Post-COVID-19 Syndrome: A Shift in the Frequency Across Pandemic Phases.
2026Ghali, Alaa et al.·Journal of clinical medicine·Observational
E2CohortPEM ?
Plasma Extracellular Vesicle Surface Marker Profiling Reveals Immune Cell-Associated Mitochondrial Membrane Potential Alterations in Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
2026Ikeda, Gentaro et al.·Open forum infectious diseases·Cross-Sectional
E2CohortPEM ?
Comprehensive Immunophenotyping of Monocytes and Dendritic Cells Suggests Distinct Pathophysiology in Chronic Fatigue Syndrome and Long COVID.
2026Petrov, Steliyan et al.·International journal of molecular sciences·Cross-Sectional
E2CohortPEM ?
Central noradrenergic deficiency in post-infectious chronic fatigue: neurobehavioral correlates.
2026Aregawi, Lillian et al.·Brain communications·Cross-Sectional
E2CohortPEM ?
Comparable Immune Alterations and Inflammatory Signatures in ME/CFS and Long COVID.
2025Petrov, Steliyan et al.·Biomedicines·Cross-Sectional
E2CohortPEM ?
Cognitive Impairments in Two Samples of Individuals with ME/CFS and Long COVID: A Comparative Analysis.
2025Sirotiak, Zoe et al.·Journal of clinical psychology in medical settings·Cross-Sectional
E2CohortPEM ?
Sleep and circadian rhythm alterations in myalgic encephalomyelitis/chronic fatigue syndrome and post-COVID fatigue syndrome and its association with cardiovascular risk factors: A prospective cohort study.
2024Zerón-Rugerio, María Fernanda et al.·Chronobiology international·Observational
E2CohortPEM ✓
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After SARS-CoV-2 Infection.
2024Unger, Elizabeth R et al.·JAMA network open·Longitudinal
E2PEM ?
Longterm course of neuropsychological symptoms and ME/CFS after SARS-CoV-2-infection: a prospective registry study.
2024Reuken, P A et al.·European archives of psychiatry and clinical neuroscience·Registry-Resource
E2CohortPEM ?
Post-Acute Sequelae of COVID-19 (PASC) in Pediatrics: Factors That Impact Symptom Severity and Referral to Treatment.
2023Soprano, Catherine M et al.·Children (Basel, Switzerland)·Observational
E2CohortPEM ✓
ME/CFS and Post-Exertional Malaise among Patients with Long COVID.
2022Jason, Leonard A et al.·Neurology international·Cross-Sectional
E2CohortPEM ?
A Comprehensive Examination of Severely Ill ME/CFS Patients.
2021Chang, Chia-Jung et al.·Healthcare (Basel, Switzerland)·Cross-Sectional
E2CohortPEM ?
Shadow Burden of Undiagnosed Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) on Society: Retrospective and Prospective-In Light of COVID-19.
2021Araja, Diana et al.·Journal of clinical medicine·Observational
E3ReviewPEM ?
Considerations for Long COVID Rehabilitation in Women.
2025Verduzco-Gutierrez, Monica et al.·Physical medicine and rehabilitation clinics of North America·Review-Narrative
E3ReviewPEM ?
Developing a clinical-pathological framework of long COVID-related fatigue applied to public safety workers.
2024Lofrano-Porto, Adriana et al.·Frontiers in medicine·Review-Narrative
E3ReviewPEM ?
Fatigue in Post-Acute Sequelae of Coronavirus Disease 2019.
2023Abbott, Zachary et al.·Physical medicine and rehabilitation clinics of North America·Review-Narrative
E3CohortPEM ✗
New Clinical Phenotype of the Post-Covid Syndrome: Fibromyalgia and Joint Hypermobility Condition.
2022Gavrilova, Natalia et al.·Pathophysiology : the official journal of the International Society for Pathophysiology·Case-Control
E3GuidelinePEM ?
Postacute Sequelae of SARS-CoV-2 Infection-Lessons Learned From a Coordinated Health System Response.
2022Ganesh, Ravindra et al.·Mayo Clinic proceedings. Innovations, quality & outcomes·Guideline
E3PEM ?
Myalgic encephalomyelitis/chronic fatigue syndrome post coronavirus disease 2019.
2022Kusama, Yoshiki et al.·Pediatrics international : official journal of the Japan Pediatric Society
E3ReviewPEM ?
Gulf War Illness: A Historical Review and Considerations of a Post-Viral Syndrome.
2026Bast, Elizabeth et al.·Military medicine·Review-Narrative
E3ReviewPEM ?
The lingering shadow of epidemics: post-acute sequelae across history.
2026Miller, Christine M et al.·Trends in immunology
E3ReviewPEM ?
Mitochondrial Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
2025Syed, Abu Mohammad et al.·Physiology (Bethesda, Md.)·Review-Narrative
E3CommentaryPEM ?
Post-infective myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-COVID as two puzzling faces of the same medal. Recent insights.
2025Chirumbolo, Salvatore et al.·International immunopharmacology·Editorial
E3CommentaryPEM ?
Long Covid in Year 5: Some Progress, Still Many Questions.
2025Meagher, Timothy·Journal of insurance medicine (New York, N.Y.)·Editorial
E3ReviewPEM ?
[Myalgic encephalomyelitis/chronic fatigue syndrome as a complication of COVID-19 post-acute syndrome in adults. Bibliographic Review].
2024Carrillo Uguña, Miguel Esteban et al.·Vertex (Buenos Aires, Argentina)·Review-Narrative
E3CommentaryPEM ?
Long COVID: a new disease?
2024Mirofsky, Matias et al.·Medicina·Editorial
E3GuidelinePEM ?
Designing and optimizing clinical trials for long COVID.
2024Vogel, Julia Moore et al.·Life sciences·Guideline
E3ReviewPEM ?
Long COVID: major findings, mechanisms and recommendations.
2023Davis, Hannah E et al.·Nature reviews. Microbiology·Review-Narrative
E3ReviewPEM ?
Unexplained post-acute infection syndromes.
2022Choutka, Jan et al.·Nature medicine·Review-Narrative
E3ReviewPEM ?
COVID-19 and chronic fatigue syndrome: An endocrine perspective.
2022Bansal, Rashika et al.·Journal of clinical & translational endocrinology·Review-Narrative
E3CommentaryPEM ?
Insights from myalgic encephalomyelitis/chronic fatigue syndrome may help unravel the pathogenesis of postacute COVID-19 syndrome.
2021Komaroff, Anthony L et al.·Trends in molecular medicine
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