Chronic fatigue syndrome: an emerging sequela in COVID-19 survivors?, 2021, Mantovani et al

Abstract

SARS-CoV-2 survivors may report persistent symptoms that resemble myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We explored (a) ME/CFS-like symptom prevalence and (b) whether axonal, inflammatory, and/or lung changes may contribute to ME/CFS-like symptoms in SARS-CoV-2 survivors through clinical, neuropsychiatric, neuropsychological, lung function assessment, and serum neurofilament light chain, an axonal damage biomarker.

ME/CFS-like features were found in 27% of our sample. ME/CFS-like group showed worse sleep quality, fatigue, pain, depressive symptoms, subjective cognitive complaints, Borg baseline dyspnea of the 6-min walking test vs. those without ME/CFS-like symptoms. These preliminary findings raise concern on a possible future ME/CFS-like pandemic in SARS-CoV-2 survivors.


Open access: https://link.springer.com/article/10.1007/s13365-021-01002-x

 

I would love to tap like to this but its a nightmare scenario. Good for the prospect of real research funding, bad for everyone else. So consider this a like for the post, a like for the research prospects, but a dislike for the risk of all those new ME patients.

PS Only partly read the paper so far, but it uses ME ICC criteria, not CFS criteria. Interesting.

 

I had a simple dementia verbal memory test over a decade ago. I thought it probably a waste of time but went along with it. I aced it, only missing I think one or two items on a long list over three times. Curiously it was the second iteration where I missed one or two, not the first. My specific cognitive deficits were ignored, and a long list I gave them first was placed in the little round filing system on the floor. Cognitive tests that do not address a patient's specific issues are deceptive at best, usually useless, and frequently harmful by leading to dubious conclusions.

 

Using poor cognitive testing protocols might get some results that are useful in extremely large cohorts where small differences in cognition might be detected. Not so great in tiny cohorts, deceptive as I already stated.

 

Most people get better at these tests as they get the hang of it. People with ME get tired so their score drops but they never repeat the test often enough.

The deficits in ME are actually very easy to find but they are so unique to us that we need our own specialised tests. In the 80s I read about a doctor who got his nurse to give patients in the waiting room a clip board and asked them to write out some of their symptoms. In people with ME their writing deteriorated badly.

Studies have shown that people with ME can often do cognitive tests but that they use more effort to do so.

If scientist thought about ME as a physical disease, let's lose "functional" as a description for a start, then they would be more willing to look at what the consequences would be of having a problem with energy production.
Then it would be possible to develop simple (cheap!) tests that would be indicative of the disease.

 

Coming back from that testing was a nightmare. My energy crashed so badly I could not lift my feet even an inch, so could not use even a single step. I eventually found a taxi, came home, and crashed into bed. It was a cognitive test but I physically crashed. They never consider energy deficits from my experience.

 

"Emerging", uh? Sounds a lot like "here's my 6' 200 lbs child". It's been 16 months.

Fitting that such people would trot out the functional crap.

 

Exactly. Unless the test was performed prospectively (before illness) for comparison, claims that there is no reduction in performance are not valid.

 

In case it's of use here's a twitter thread from ME Association about this research paper:

Quote from Dr. Shepherd: "Some of the content and referencing in this paper indicates that this research group from Verona in Italy are not used to working with ME/CFS patients and are not fully up to speed on ME/CFS research. However, it's good to see that researchers are taking the link between Long Covid and ME/CFS seriously and are starting to publish papers on the overlaps."