Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome 2022 Ghali et al

Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. Studies that examined predictors of ME/CFS outcomes yielded contradictory results.

We aimed to explore epidemiological and clinical prognostic factors of ME/CFS using operationalized criteria for recovery/improvement. Adult ME/CFS patients who attended the Internal Medicine Department of Angers University Hospital, Angers, France between October 2011 and December 2019, and were followed up until December 2020, were included retrospectively. Their medical records were reviewed for data collection.

Patients were classified into two groups according to the presence or absence of recovery/improvement (R/I) and compared for epidemiological characteristics, fatigue features, post-exertional malaise severity, clinical manifestations, and comorbidities.

The subgroups of recovered and significantly improved patients were then compared. 168 patients were included. Recovery and improvement rates were 8.3% and 4.8%, respectively. Older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.007–1.110] (p = 0.028)), while diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.964–0.996] (p = 0.036)).

The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age.

https://www.mdpi.com/2075-4418/12/10/2540

 

Good to see some more data to this, although the prognosis still looks like the rough 5% we have seen before. Its not very likely we recover.

 

Main findings seem to be:

Out of the included 168 patients, only 14 (8.3%) showed complete recovery. Patients were considered recovered if they "were no longer experiencing PEM for at least 6 months, reported complete remission of their baseline symptoms, and were able to perform their premorbid levels of physical, cognitive, social, and occupational functioning without pacing strategies or taking medications."

They also looked at patients who experienced a significant improvement which was only the case for an additional 4.8% of patients, much lower than that reported in the literature (17% to 64%).

The authors compared the data of the improved/recovered group versus the rest of the cohort when they first visited the clinic. The patients who recovered or improved where a bit older when they got the illness and they were diagnosed sooner than the other patients. They also had less IBS.

It's quite remarkable that there was no significant differences on the many other measures such as fatigue, pain or PEM severity, sudden onset or not, having an infectious trigger etc.​