Shared autonomic phenotype of long COVID and myalgic encephalomyelitis/chronic fatigue syndrome, 2026, Novak, Systrom+

@Jonathan Edwards Understood.

I suppose the stated purpose of this study was to show similar rates of autonomic dysfunction across ME/CFS, Long Covid, and hEds rather than prove that these disease groups show higher rates of dysfunction as compared to healthy controls. But then why even include the healthy control group at all? All this proves is that these disease groups have more autonomic dysfunction than healthy people without autonomic dysfunction, which is redundant.

I am actually a patient of Dr. Novak's and am going in for this testing (transcranial doppler, sweat test, SFN skin biopsy, tilt test with CBFv) in a few weeks. I have had nothing but normal lab results in my 11 months of ME/CFS, so I was hoping I could use those results to state (at least to myself) that there is some evidence of biological dysfunction, but I don't think that's the case.
 
bspielvogel94 said:
I'm confused by the language describing inclusion criteria for healthy controls. It reads:

"The Long COVID and ME/CFS subjects were compared to a healthy control group from our autonomic research database at the University of Massachusetts [28]. All healthy controls were asymptomatic and had normal responses to tilt in heart rate, blood pressure, CBFv and respiratory variables."

Isn't that circular logic? As in, if you're selecting only the healthy controls that do not display autonomic abnormalities, then you're not able to make a true comparison to the disease groups. Wouldn't you want to take a random assortment of healthy controls and then test them to establish the baseline of autonomic abnormalities in the general population? Perhaps there are significant rates of reduced CBFv in the general population, but this study doesn't tell us anything about that.
Click to expand...
Yes, it appears to be circular. Good catch!
 
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