Do you believe that “viral persistence” is the cause of ongoing MECFS and LC?

They may be yet to find million new things about virus, I don't know. The problem with any old/new findings about virus is that they don't explain anything other than fatigue, never mind making any testable prediction. (Well, ok, some did predict that antivirals would be effective and failed the test). Frankly, I don't see how virus can explain PEM and that's where my objection to viral theories is centered on: no virus theory I know of even tries to explain PEM.

 

It might be true for a small number of ME/CFS cases, but it is not true for the persistence of LongCOVID.

 

I'd understand saying it's unlikely, but I don't see how you can be sure that viral persistence doesn't cause long COVID. We're continually seeing new evidence of SARS-CoV-2 antigen persistence as technology improves. How can you be sure, for example, that we won't eventually find something like 100% of LC and 0% of controls have the virus in one specific region of the brain where it can cause these symptoms?

 

The immune system deliberately preserves antigen fragments for years, that is how we maintain serological (antibody) responses.

If there is viral infection, and it is not 100% dormant (true dormancy is only possible for a few viruses and it isn't actively causing disease when dormant either), there will spillover of viral RNA into circulation and this can be detected.


Mouse models show that antigens are captured and maintained for years.

"Follicular dendritic cells: dynamic antigen libraries"
https://www.nature.com/articles/nri3689

 

This is interesting. No live virus has been found in tissue without spilling into blood? If the virus was in the brain, where SARS-CoV-2 is known to be able to replicate, I'd think it'd be less likely for this to occur, given the BBB.

 

I hope we get a small brain autopsy study into people with Post-COVID ME/CFS with atleast 4 years since last COVID infection.

It would tell us if all this hype is really worth it, or if we can put the persistence theory to rest once and for all.

My personal hunch is that the development of ME/CFS will be associated with RNA fragments and perhaps in some cases minor persistence lasting longer than the average, setting off some problematic feedback loop, but that in no means does any virus have to be persistent for someone to have ME.