COVID-19 and post-infectious myalgic encephalomyelitis/chronic fatigue syndrome: a narrative review, 2021, Poenaru et al

Abstract

Coronavirus disease 2019 (COVID-19) is a viral infection which can cause a variety of respiratory, gastrointestinal, and vascular symptoms. The acute illness phase generally lasts no more than 2–3 weeks. However, there is increasing evidence that a proportion of COVID-19 patients experience a prolonged convalescence and continue to have symptoms lasting several months after the initial infection. A variety of chronic symptoms have been reported including fatigue, dyspnea, myalgia, exercise intolerance, sleep disturbances, difficulty concentrating, anxiety, fever, headache, malaise, and vertigo. These symptoms are similar to those seen in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a chronic multi-system illness characterized by profound fatigue, sleep disturbances, neurocognitive changes, orthostatic intolerance, and post-exertional malaise. ME/CFS symptoms are exacerbated by exercise or stress and occur in the absence of any significant clinical or laboratory findings. The pathology of ME/CFS is not known: it is thought to be multifactorial, resulting from the dysregulation of multiple systems in response to a particular trigger. Although not exclusively considered a post-infectious entity, ME/CFS has been associated with several infectious agents including Epstein–Barr Virus, Q fever, influenza, and other coronaviruses. There are important similarities between post-acute COVID-19 symptoms and ME/CFS. However, there is currently insufficient evidence to establish COVID-19 as an infectious trigger for ME/CFS. Further research is required to determine the natural history of this condition, as well as to define risk factors, prevalence, and possible interventional strategies.

Open access, https://journals.sagepub.com/doi/full/10.1177/20499361211009385

 

And ENTEROVIRUSES How can you trust the work of anyone who has no knowledge of the history of ME? I get angry at these so called scientists who write people like me out of history.

 

I don't want to be associated with any paper that uses PG as a reference.

"This stuff is real. People are ill. Doctors need to stop diagnosing this as anxiety. We have messed up before, lets’ not do it again with long term covid-19 illness.

Paul Garner, Professor at the Liverpool School of Tropical Medicine. He is Director of the Centre for Evidence Synthesis in Global Health and Co-ordinating Editor of the Cochrane Infectious Diseases Group".

 

Are there any solid prospective studies on entroviruses and ME? I had the impression that there weren't many good studies there, but I haven't kept up with more recent publications.

 

This research was done through the Ottawa Hospital research centre Ontario. The authors are from the epidemiology dept.

It looks at least like there was an attempt to come to grips with whatever is going on for people with long-term symptoms after covid and relating them to ME.

Their list of references is pretty free range including many names we know from BPS but also L Jason, Tom Kindlon, Behan, Fane Mensah, Twisk.

When the new NICE guidance comes out if it is substantially the same as the draft then this will be good as papers reference the need to consider harm from exercise therapy.

Also, anyone doing research needs to follow at least one group who do nothing to find out the prevalence for how many cases resolve on their own. I think this would be a very good figure to have provided it's done right (and I don't know how that would be). That might be worth doing internationally and I would think it to not be overly expensive.

NB

I didn't read through the body of the text.

ETA words for clarity (as the draft)

 

I am not talking about doing studies on enteroviruses, it is the fact they are getting written out of history that gets to me.

Even without the historical association with enteroviruses and ME they are common but can cause many different problems and have a complicated life cycle. The sad fact is it is difficult to research enteroviruses so easier to ignore them.

 

But if there aren't solid studies it's understandable for researchers to not mention them in their summary of infections associated with ME. An abstract is only going to be a brief introduction. I've not read the paper yet, but imo it's worth keeping criticisms to as solid ground as possible, especially if the authors are going to be googling their work to see the response is. We've had to endure a lot of poor work that has undermined our instinctive respect for a lot of the processes around science but it's worth trying to avoid that leading to instinctive derision.

 

There are many of us who became ill after an enteroviral infection. If enteroviruses are not to be considered in a list of things that lead to ME then why should we be looking at long covid when there is no proof?

I am too tired to argue with you. I am tired of the long years since CFS was invented and upset that so many people who claim to be interested in ME have thrown those of us from then away and finished off the work of the likes of Wessely. He said he was going to destroy the idea of ME and he has succeeded in destroying the experience of many of us who had it then.