Post-corona fatigue-a familiar picture in a new guise?, 2022, Buchberger et al

Abstract

Background
Myalgic encephalitis or chronic fatigue syndrome (ME/CFS) has again come into focus as a result of coronavirus disease 2019 (COVID-19). Fundamentally problematic is the fact that ME/CFS is considered a separate entity; however, extreme fatigue is also a common symptom of an underlying disease. Our article aims to increase the acceptance of ME/CFS and extreme fatigue facing a symptomatology that is not fully understood, and to highlight the need for research, orientation for physicians, and counselling services for patients.

Materials and methods
Orientative research by focused information gathering.

Results
In various research projects, the hypothesis of post-infectious ME/CFS as an autoimmune disease could be confirmed. In general, the heterogeneity of diagnostic criteria as well as the variety of formulations to describe the symptomatology and different coding options make it difficult to clearly assign symptoms to a clinical picture. Exertion intolerance has been identified as a severe symptom of post-COVID-19 disorder. For this reason, recommendations in international guidelines are currently being revised, especially with regard to pacing. The implications for recommendations in tumor-related fatigue or due to multiple sclerosis are unclear.

Conclusion
Against the background of a decreasing burden of disease due to increasing vaccination rates, research on fatigue should not only include viral diseases.

Abstract only in English, paper in German.

Open access, https://link.springer.com/article/10.1007/s00761-022-01102-1

 

This does have the look of an article that is placing a 'claim' to a share of ME/CFS research, this bit seems to cover that although they are making a point about viral/versus non viral (translation from German to English via Google:

"The current research agendas on ME/CFS such as B. the Institute for Quality and Efficiency in Health Care, which was requested by the Federal Ministry of Health in February 2021 to implement the decision of the European Parliament to increase support for research activities to prepare a report on ME/CFS [ 27 , 28 ], or three company health insurance funds with financing from the innovation fund and in cooperation with the Charité Fatigue Centrum as well as a research project commissioned by the Dutch government from the national HTA Agency [ 29] are focused on viral fatigue.

For non-postviral patients with fatigue, the question arises as to what the results from current research mean, for example, for tumor-associated fatigue or fatigue in MS and what the consequences are for the diagnosis, therapy and management of these patients. Is a paradigm shift emerging? May need to be stratified by ME, CFS, ME/CFS and SEID ?"

The authors quote NICE 2021 with seeming approval:

"In contrast to the recommendations for tumor-associated fatigue, the National Institute for Health and Care Excellence (NICE) UK guidance on the diagnosis and management of ME/CFS, published October 2021, notes that programs for a gradual increase in physical activity or Training should not be offered to treat ME/CFS. This is because of the harms reported by people with ME/CFS. Instead, it emphasizes the importance of making sure people stay within their “energy zone” when engaging in activities. In addition, it is recommended that physical activity programs for people with ME/CFS should only be considered in certain circumstances."

and

"It also emphasizes that cognitive behavioral therapy (CBT) is not a treatment or cure for ME/CFS. CBT may be suitable as an adjuvant therapy to manage symptoms and improve well-being and quality of life."

The authors also state (translation is a bit weird) :

"The authors seem to find it more expedient to carry out comparative research for patients suffering from extreme fatigue with different disease entities [ 30 ] and to conduct interdisciplinary research into etiology, pathophysiology and possible therapies. In the interests of the patient's well-being and with the appeal for the consideration and consideration of often long suffering and high levels of suffering, various specialist societies must be called upon to cooperate, as has been the practice for a long time, for example, in the oncological guideline program or the Social Committee of the German Diabetes Society."

and have a final conclusion about research direction:

• "ME/CFS is a separate entity, but extreme fatigue as part of ME/CFS is also a common symptom of an underlying condition such as cancer or multiple sclerosis.
  
  
• In order to be able to better advise, accompany and refer patients with extreme fatigue, the usability of diagnostic tools must be improved.
  
  
• In a symptom-oriented therapy, you can benefit from the expertise of various disciplines. This applies in particular to the design of pacing and coping, because the interactions of the individual symptoms such as exhausted psychosocial compensation options, pain, disturbed sleep and the consequences of physical inactivity remain a major challenge for the complex symptomatology.
  
  
• Patients with tumor-associated fatigue or fatigue in multiple sclerosis should therefore not be excluded from current research on fatigue."
  

which I take to mean that they want to include ME/CFS in fatigue research but not exclusively look at ME/CFS from a post infection perspective. Which if correct, I would enthusiastically applaud.

 

The lead author works at a different university than the neurologist. She has a degree in Public Health. The article is published in an oncology journal, sounds sympathetic but I don't really understand the message either.