Insights from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome may help unravel the pathogenesis of post-acute COVID-19 syndrome, by Anthony L Komaroff, W Ian Lipkin in Trends in Molecular Medicine, 7 June 2021 [doi.org/10.1016/j.molmed.2021.06.002]
Highlights:
- In some people, the aftermath of acute coronavirus disease 2019 (COVID-19) is a lingering illness with fatigue and cognitive defects, known as post–COVID-19 syndrome or ‘long COVID.’
- Post–COVID-19 syndrome is similar to postinfectious fatigue syndromes triggered by other infectious agents and to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a condition that patients often report is preceded by an infectious-like illness.
- ME/CFS is associated with underlying abnormalities of the central and autonomic nervous systems, immune dysregulation, disordered energy metabolism, and redox imbalance. It is currently unclear if the same abnormalities will be identified in post–COVID-19 syndrome.
- The USA and other developed nations have committed considerable support for research on post–COVID-19 illnesses.
Review abstract:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause chronic and acute disease. Postacute sequelae of SARS-CoV-2 infection (PASC) include injury to the lungs, heart, kidneys, and brain that may produce a variety of symptoms. PASC also includes a post–coronavirus disease 2019 (COVID-19) syndrome (‘long COVID’) with features that can follow other acute infectious diseases and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
Here we summarize what is known about the pathogenesis of ME/CFS and of ‘acute’ COVID-19, and we speculate that the pathogenesis of post–COVID-19 syndrome in some people may be similar to that of ME/CFS.
We propose molecular mechanisms that might explain the fatigue and related symptoms in both illnesses, and we suggest a research agenda for both ME/CFS and post–COVID-19 syndrome.
Comment from Health rising: Experts Assert Insights From ME/CFS Needed to Understand Long COVID
We’re just beginning to learn about long COVID, but some possible connections have shown up. Besides the wide overlap in symptoms, the mixed results from attempts to find evidence of the virus in the central nervous system suggest that it’s the “host response to the virus and microvascular damage” occurring from that – rather than the direct effects of the virus – that is probably causing symptoms. Indeed, they believe the virus probably does much of its damage via its effects on the vascular system (blood vessels). The widespread “microinfarcts” found in COVID-19 could be contributing to the cognitive problems found.
These findings alone present plenty of potential overlap with ME/CFS and fibromyalgia, with several studies suggesting the microcirculation, in particular, has been disturbed.
