Post-COVID-19 ME/CFS: a case report of the treatment and recovery of a 17-year-old high-school student, 2026, Oka

forestglip

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Post-COVID-19 ME/CFS: a case report of the treatment and recovery of a 17-year-old high-school student

Oka, Takakazu

Background
Evidence is accumulating that some patients infected with SARS-CoV-2 develop persistent fatigue and cognitive dysfunction that meets the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (post-COVID-19 ME/CFS). However, no established treatment exists for this condition, and reports of patients who have recovered remain limited.

Because the pathophysiologic mechanisms underlying the disabling symptoms of post-COVID-19 ME/CFS are not yet fully understood, I adopted a multifaceted treatment approach that considers disease severity, functional level, illness beliefs and coping behaviors, social support systems, comorbidities, secondary issues, and phase of recovery.

This report describes a high-school student with post-COVID-19 ME/CFS who was, at one point, unable to attend school but ultimately recovered through this comprehensive, multiperspective treatment strategy.

Case presentation
A 17-year-old girl was referred to my department for severe fatigue that developed after SARS-CoV-2 infection. Despite receiving treatments at other medical facilities, she was still bedridden for more than half of each day.

I treated the patient from multiple perspectives, including (1) instruction on eating habits and supplements; (2) instruction on physical activities; (3) instruction on managing cognitive fatigue; (4) environmental adjustment; (5) pharmacotherapy with midodrine, ibudilast, and the traditional Japanese herbal medicines hochuekkito and tokishakuyakusan; (6) facilitation of therapeutic interoceptive awareness; (7) adjustment of disrupted diurnal sleep-wake rhythms; (8) conditioning exercise; (9) instructions for safe recovery; and (10) nurturing self-efficacy. These interventions were introduced progressively, tailored to the patient’s phase of recovery.

Approximately one year after her initial consultation, the patient made a full recovery, entered university, and is now enjoying university life.

Conclusions
This case report describes, in detail, the evaluation and multifaceted treatment of a 17-year-old high-school student with post-COVID-19 ME/CFS who had been unable to attend school but who ultimately recovered and was able to attend university.

Web | DOI | PDF | BioPsychoSocial Medicine Open Access
 
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Liii said:
To their credit this abstract is exemplary clear and concrete.
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True, but it left out one crucial fact. She had only been ill for 9 months at the start of treatment, did mutiple treatments and it took another year for her to recover. So the whole thing was over in less than 2 years.

Natural recovery seems the most likely explanation. Who knows, maybe if she didn't get confronted with such a long list of treatments including activity based, and had been able to convalesce quietly at home, she might have recovered faster.
 
Trish said:
True, but it left out one crucial fact. She had only been ill for 9 months at the start of treatment, did mutiple treatments and it took another year for her to recover. So the whole thing was over in less than 2 years.
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They at least kind of mentioned it in the limitations section. (bolding added)
There are several limitations to this case report. First, it is difficult to determine which components of the intervention contributed most to the patient’s recovery. Second, distinguishing the observed improvement from the natural course of recovery remains challenging. Third, further research is required before this treatment approach can be generalized to all individuals with this illness, particularly adult patients or those with very severe incapacitation. Nevertheless, as this patient is one of six with post–COVID-19 ME/CFS who demonstrated recovery following this multifaceted treatment strategy [16]: the success of this approach suggests that a comprehensive treatment plan would be beneficial for some individuals with post–COVID-19 ME/CFS.
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forestglip said:
A 17-year-old girl was referred to my department for severe fatigue that developed after SARS-CoV-2 infection. Despite receiving treatments at other medical facilities, she was still bedridden for more than half of each day.

I treated the patient from multiple perspectives, including (1) instruction on eating habits and supplements; (2) instruction on physical activities; (3) instruction on managing cognitive fatigue; (4) environmental adjustment; (5) pharmacotherapy with midodrine, ibudilast, and the traditional Japanese herbal medicines hochuekkito and tokishakuyakusan; (6) facilitation of therapeutic interoceptive awareness; (7) adjustment of disrupted diurnal sleep-wake rhythms; (8) conditioning exercise; (9) instructions for safe recovery; and (10) nurturing self-efficacy. These interventions were introduced progressively, tailored to the patient’s phase of recovery.

Approximately one year after her initial consultation, the patient made a full recovery, entered university, and is now enjoying university life.
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For goodness sake. Seems like the author didn't get the memo that recovery within two years is the most likely outcome.

I could write somewhat similar case studies about my two children, who were both unwell with ME/CFS and who both went on to be able to attend university and live happy lives.
I would finish with this:
The success of my approach suggests that supportive parenting without a saviour complex and primarily the passage of time would be beneficial for some individuals with post-viral ME/CFS. Further research is required before this treatment approach could be generalised to all individuals with this illness.
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