A logistic regression analysis of risk factors in ME/CFS pathogenesis. Lacerda et al. 2019

https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1468-2

 

I was curious about what "frequent colds" means since it's hard to assess for a whole life, memory being unreliable and all that, and it's:

Which makes more sense. That was my experience but I'm not sure if they were actually regular colds or flus, they seemed a bit different but not being able to say otherwise I would agree that it's close enough. Could be a prodromal phase of ME, however.

There is an additional variable for "History of frequent colds/flu" but "within the 6 months prior to disease onset" is 3x more significant. I have no idea what is a normal history of colds/flus and where I stand on this.

Young age being a risk factor to disease severity really, really makes a strong case for a full stop on all behavioral experiments that are based on a belief that there is no disease and using ignoring symptoms as treatment. This needs to be replicated and validated ASAP considering that there is a growing effort by Chalder, Crawley and the like at exposing children and teens to their nonsense, a more pliable and captive population that can't complain.

Despite the fact that younger people seem to have better prognostic, it looks to be a risk factor in developing severe ME:

Could be significant to check whether this is a result of bad advice, of pushing through, for those who did not recover.

Family history of neurological disease seems pretty significant, those numbers are way above the norm, although hard to tell with a small sample:

My maternal grandmother had Parkinson's and neuropathy while my paternal grandmother had Alzheimer's. Pretty much everyone else died of cancer rather young so it's impossible to say what would have developed.

This refers to a 2008 study (Chia JK, Chia AY. Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach. J Clin Pathol. 2008;61(1):43–8.):

Still impressively high that 20% have those viral proteins.

About the "association" with psychiatric co-mobordities, people who don't cherry-pick oddly don't find cherries:

 

I had frequent cold/flu from 10 years old onward -- enough so that I usually missed about 20+ days of school each year. Looking back now, I can't tell if I was getting the flu or a cold that often or was just experiencing PEM. My flu-like days were just that, flu-like. Chills, prostration, icky-sick feeling, loose stools, and maybe a low-grade fever and/or sore throat--basically, what I feel now except then it was only a day or two every few weeks. Colds did have the usual sinus congestion, post-nasal drip, cough (in fact, they usual followed a distinct pattern starting with nasal congestion and then ending with chest congestion). When the chest congestion hit, I'd take some NyQuil so I could sleep and wake up miraculously cured the next morning. I have no idea why.

 

Keep in mind that studies of this kind are of 'suggestive' quality evidence only. Retrospective studies of risk factors that rely on what is still basically a convenience sample, despite claims of it being cross-sectional are not conclusive.

 

I'd suspect that the connection between frequent colds and infections and the risk of ME/CFS is indirect; that is, there's probably not a shared "weakness" that results in both frequent cold/infections and ME/CFS, but rather that ME/CFS is often triggered by colds and infections. The more colds and infections you have, the greater the chance that one of them will be severe enough to trigger ME/CFS.

 

It seems that ME/CFS patients reported a little more of most things but that nothing really stood out.

I suspect that these kinds of retrospective studies are mostly useful to exclude hypotheses and indicate that some things aren't important. Otherwise one would expect a much clearer difference in (recent) exposures such as living on a farm, radiation, flooding, head injury or major operations etc.

Only 10% said they had a family history of ME/CFS (compared to 5.7% in the healthy controls). ME/CFS patients seemed to have less alcohol consumption than controls but it's difficult to interpret how significant this difference was.

 

I never got a cold or flu before I became ill with M.E. at age 28. Perhaps slow onset patients experienced more colds and flu? I had a sudden onset, I know the exact time I got ill one morning.

 

My experience is that I *thought* I was getting colds and flu all the time. Then I realised this really wasn't normal and my flu seemed to follow about two to four days after 'big' days. It was really just PEM but I didn't know any better.

 

It seems to me that a possible flaw in this paper is a failure to distinguish between cases of acute and insidious onset.

Those with acute onset know the occasion of onset, and the rest don't. How does one determine the timing of a latent onset and thus say whether any frequent colds/flu pre-date or post-date that onset? Are they a predisposing or a precipitating factor EDIT or a symptom of the illness?

 

This may be a step forward from a similar study done years ago using GP records. They found that people with ME had more GP visits in the previous year with the commonest reason to see the doctor being "illegible"

 

Why do that when you can do this?

No means, no standard deviations, deliberate data opacity, improper stratification, publish known information as new information.

On the other hand, I definitely like they included BCG.

 

This

 

This.
I wonder how common that confusion between a cold and mild PEM is?

I spent years thinking I had a particularly strong immune system because whenever I caught a 'bug' I got that 'off' feeling and a sore throat but it never went on to develop into a runny nose. And I explained away the fact that I was catching 'bugs' all the time with temporarily lowered immunity after a big day. With hindsight....

I actually hardly ever got any real colds. And I never had any of the usual childhood illnesses (so I'm told anyway). But on the rare occasion I got the real flu or similar, bang: ME.

So, a link between infection and ME - yes. A link between frequent infection and ME - in my case no.

 

I know the difference between a cold and PEM - mild cough for a few days can be PEM, cough or runny nose that doesn't go away for weeks is an infection. I seem to catch at least one per year, more when I was attending uni and caught pretty much everything going around.

 

Yes, me too. The individual days off I had to take when I was working full-time to deal with what, in hindsight, was PEM my best description at the time was it was a 24-hour heavy cold.

 

I used to get frightful, mostly one-sided, sore throats and expected colds to hit the next morning but they didn't. It took an age for me to realise that they were chemical hits from gardening or household products.

 

@Nellie the "chemical hits" symptoms (one sided sore gland under my ear) started 15 years into the illness. In the last few years I find that dust/allergens are causing the exact same symptoms. Kind of hard to avoid those!

 

Because unless you know when the pathogenesis occurred you cannot hope to identify the risk factors for it.