Converging evidence of similar symptomatology of ME/CFS and PASC
A review article by independent researcher David Marks looks at the overlap in symptoms between ME/CFS and Long COVID and makes a speculative hypothesis about biological mechanisms.
Conclusions:
(1) The pattern of symptoms for ME/CFS and PASC is highly similar. Using a psychometrically reliable and validated measure, the correlation in mean symptom scores across 62 symptoms is 0.902.
(2) The waxing and waning of ME/CFS and PASC symptomatology require an explanatory hypothesis that includes a mechanism that can stabilize and destabilize in unpredictable, intermittent cycles. It is suggested that ME/CFS and PASC are the consequence of central nervous system dyshomeostasis. The hypothesis receives tentative support from a variety of sources.
(3) The theory is consistent with the ‘Energy Envelope’ theory, research on organ network interactions, and hypotheses concerning molecular mechanisms of neuroinflammation in ME/CFS and PASC.
To use an analogy of a thermostat, if the ‘off switch’ of a thermostat intermittently stops working, for periods the house would become warmer and warmer without limit.
(4) The current theory is speculative and requires in-depth investigation before definite conclusions can be drawn. Further study of mechanisms and functional studies should improve understanding of the associations between these hypotheses and etiological factors.
Converging evidence of similar symptomatology of ME/CFS and PASC indicating multisystemic dyshomeostasis, by David Marks in Biomedicines 2023, 11(1), 180 [doi.org/10.3390/biomedicines11010180]
(This article belongs to the Special Issue Feature Review Papers on Brain Diseases)
Review abstract:
The purpose of this article is to review the evidence of similar symptomatology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-acute sequelae of SARS-CoV-2 infection (PASC).
Reanalysis of data from a study by Jason comparing symptom reports from two groups of ME/CFS and PASC patients shows a notably similar symptomatology. Symptom scores of the PASC group and the ME/CFS group correlated 0.902 (p < 0.0001) across items.
The hypothesis is presented that ME/CFS and PASC are caused by a chronic state of multisystemic disequilibrium including endocrinological, immunological, and/or metabolic changes. The hypothesis holds that a changed set point persistently pushes the organism towards a pathological dysfunctional state which fails to reset.
To use an analogy of a thermostat, if the ‘off switch’ of a thermostat intermittently stops working, for periods the house would become warmer and warmer without limit.
The hypothesis draws on recent investigations of the Central Homeostasis Network showing multiple interconnections between the autonomic system, central nervous system, and brain stem. The hypothesis helps to explain the shared symptomatology of ME/CFS and PASC and the unpredictable, intermittent, and fluctuating pattern of symptoms of ME/CFS and PASC.
The current theoretical approach remains speculative and requires in-depth investigation before any definite conclusions can be drawn.
