Open Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis (ME/CFS) Registry and Biobank, COVID-19, SARS-CoV-2 (MECFS-R), Technical University of Munich

Study Overview

Brief Summary

Chronic fatigue syndrome (syn. myalgic encephalomyelitis or ME/CFS) is a relatively common, but pathogenetically still insufficiently understood, complex, severe, chronic disease. It has been classified by the WHO as a neurological disorder (ICD-10 G93.3).

The leading symptoms are pathological exhaustion (fatigue) and prolonged, inadequate deterioration of condition after exertion (syn. post-exertional malaise or PEM). In addition, pain, sleep disturbances, flu-like symptoms, and cognitive, autonomic, and neuroendocrine symptoms are typically found.

In the majority of patients*, the trigger is a viral disease, including infectious mononucleosis caused by Epstein-Barr virus (EBV), which is particularly common in young patients, but also influenza or coronavirus disease 2019 (Covid-19) at any age. Causative factors are discussed to be autoimmune mechanisms as well as a genetic predisposition.

The general activity level and quality of life of patients are usually significantly reduced due to the disease. A large proportion of those affected are confined to a wheelchair, home or bed. ME/CFS is one of the most common reasons for long absences from school due to illness.

Because no reliable biomarkers are available, ME/CFS is a diagnosis of exclusion. The diagnosis is made using internationally established clinical criteria and after careful differential diagnosis. To date, no causal, but only symptom-oriented, non-standard treatment approaches are found. With appropriate care, the prognosis in childhood and adolescence is better than in adults. Long-term recovery is possible in two-thirds of young patients, whereas less than one-third of adult patients can expect recovery.

In Germany, there are currently two special outpatient clinics for patients with ME/CFS, one for adult patients* at the Charité Fatigue Centrum in Berlin, headed by Prof. Scheibenbogen, and one for children, adolescents and young adults up to 25 years of age at the ME/CFS focus of the Children's Polyclinic of the MRI of the TUM in Munich, headed by Prof. Behrends. A joint data collection of these ME/CFS centers has not been established.

The proposed ME/CFS registry study (MECFS-R) is intended to initially pool medical data from specialized routine care on a bicenter basis and, after recruitment of additional German centers, on a multicenter, longitudinal, and web-based basis, as extensive as possible, and to make this data available for research.

Following the example of already well-established European registry studies (e.g., the ESID registry of the European Society for Immunodeficiencies), digital data acquisition should take place in a tiered approach according to cost-benefit analysis. Medical institutions can decide, based on capacity, whether a clearly defined core data set (level 1) or more complex data sets (level 2 or 3) should be digitally captured. The digital implementation is to be carried out in collaboration with the Munich-based IT company Bitcare, whose database concepts have proven successful in the context of the Transplantation Cohort (Tx Cohort) of the German Center for Infection Research (DZIF) or the Covid-19 study of the MRI of TUM (COMRI) and with whom the team at the MRI of TUM has been working successfully for many years.

The aim of the MECFS-R is to accurately describe the clinical picture and its course in Germany clinically and epidemiologically as well as to derive epidemiological or medical risk factors, if applicable, and to define subcohorts for future treatment approaches.

https://clinicaltrials.gov/study/NCT05778006