ME/CFS is common in PASC / long COVID
A US long COVID clinic found that 43% of PASC/ long COVID patients met the criteria for ME/CFS though they acknowledge that a larger more diverse group of patients might alter the figures.
“Fatigue, post-exertional malaise, brain fog, unrefreshing sleep, and daytime sleepiness were the most prevalent and severe symptoms. This commonality between ME/CFS and ME/CFS-PASC may suggest a shared pathobiology. Therefore, defining specific subtypes within the umbrella of PASC/post-COVID conditions can help us understand different pathogenic mechanisms to tailor treatment.”
Flow chart. *Positive SARC-CoV-2 test and over 28 days with symptoms. **Severe fatigue, unrefreshing sleep, PEM, and brain fog or orthostatic intolerance.
Research abstract:
Background:
The global prevalence of PASC is estimated to be present in 0·43 and based on the WHO estimation of 470 million worldwide COVID-19 infections, corresponds to around 200 million people experiencing long COVID symptoms. Despite this, its clinical features are not well-defined.
Methods:
We collected retrospective data from 140 patients with PASC in a post-COVID-19 clinic on demographics, risk factors, illness severity (graded as one-mild to five-severe), functional status, and 29 symptoms and principal component symptoms cluster analysis. The Institute of Medicine (IOM) 2015 criteria were used to determine the Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) phenotype.
Findings:
- The median age was 47 years,
- 59.0% were female;
- 49.3% White, 17.2% Hispanic, 14.9% Asian, and 6.7% Black
- Only 12.7% required hospitalization.
- Seventy-two (53.5%) patients had no known comorbid conditions.
- Forty-five (33.9%) were significantly debilitated. The median duration of symptoms was 285.5 days, and the number of symptoms was 12.
The most common symptoms were;
- fatigue (86.5%),
- post-exertional malaise (82.8%),
- brain fog (81.2%),
- unrefreshing sleep (76.7%), and
- lethargy (74.6%).
Forty-three percent fit the criteria for ME/CFS, majority were female, and obesity (BMI > 30 Kg/m2) (P = 0.00377895) and worse functional status (P = 0.0110474) were significantly associated with ME/CFS.
Interpretations: Most PASC patients evaluated at our clinic had no comorbid condition and were not hospitalized for acute COVID-19.
One-third of patients experienced a severe decline in their functional status. About 43% had the ME/CFS subtype.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic, by Hector Bonilla, Tom C Quach, Anushri Tiwari, Andres E Bonilla, Mitchell Miglis, Phillip C Yang, Lauren E Eggert, Husham Sharifi, Audra Horomanski, Aruna Subramanian, Liza Smirnoff, Norah Simpson, Houssan Halawi, Oliver Sum-Ping, Agnieszka Kalinowski, Zara M Patel, Robert William Shafer, Linda C Geng in Front Neurol. 2023 Feb 24;14:1090747; [doi:10.3389/fneur.2023.1090747]
Prof Leonard Jason
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