A case of post-COVID-19 ME/CFS characterized by post-exertional malaise and low serum acylcarnitine level 2023 Jinushi et al

[Andy]

Full title: A case of post-COVID-19 myalgic encephalomyelitis/chronic fatigue syndrome characterized by post-exertional malaise and low serum acylcarnitine level

Abstract
COVID-19 afflicts patients with acute symptoms and longer term sequelae. One of the sequelae is myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which is often difficult to diagnose, having no established tests. In this article, we synthesize information from literature reviews on patients with ME/CSF that developed after recovery from COVID-19.

Open access, https://onlinelibrary.wiley.com/doi/10.1002/ccr3.6930

 

[InitialConditions]

Abstract
COVID-19 afflicts patients with acute symptoms and longer term sequelae. One of the sequelae is myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which is often difficult to diagnose, having no established tests. In this article, we synthesize information from literature reviews on patients with ME/CSF that developed after recovery from COVID-19.

 

[Trish]

The idea of the paper was to find the symptoms of Long Covid that would lead to a diagnosis of ME/CFS.

...two factors were especially salient for our patient and, therefore, were pivotal in directing our attention to the possibility of ME/CFS in the context of post-COVID recovery. The first factor is PEM, which is clearly stated in the diagnostic criteria. When a patient presents with concerns of muscle pain or weakness, the treating physician will often advise exercise, which, in turn, may exacerbate rather than ameliorate the disease and prompt further psychological distress. In ME/CFS, any form of strenuous exercise should be avoided. In contrast, graded exercise therapy and cognitive behavioral therapy have been reported to be safe and effective.12

The second factor that led to an accurate diagnosis of ME/CFS for our patient was serum acylcarnitine level. A literature search for “(‘acylcarnitine’[tiab]) AND (‘fatigue syndrome, chronic’[MeSH] OR ‘chronic fatigue syndrome’[tiab] OR ‘myalgic encephalomyelitis’[tiab] OR ‘systemic exertion intolerance disease’[tiab])” on PubMed revealed 13 references, of which only four were from the last 20 years.5, 13-15 Despite varied opinion in these references about the precise role of l-carnitine in fatty acid oxidation, there is common agreement that ME/CFS is associated with changes in acylcarnitine and l-carnitine homeostasis.16 Viral infections are known to disrupt the mitochondrial fatty acid oxidation cascade,17 thus potentially contributing to a decrease in serum acylcarnitine.

The nett result seems to be a superficial look through some old ME/CFS research papers, and the conclusion that PEM is key, and can be treated with CBT/GET, and 'there is common agreement that ME/CFS is associated with changes in acylcarnitine and l-carnitine homeostasis', (and a finding of low acetylcarnitine in their one Long Covid patient).

Neither of which is true.

Not exactly groundbreaking science. How did this get published without them at least checking with a few more patients.