Current insights into complex Post-infection Fatigue Syndromes with unknown Aetiology: The case of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and beyond, by Francisco Westermeier, Eliana Mattos Lacerda, Carmen Scheibenbogen and Nuno Sepúlveda in Front. Med., 24 February 2022 [doi.org/10.3389/fmed.2022.862953]
Excerpts from journal editorial:
With the WHO notification of the COVID-19 as a pandemic on March 11, 2020, our third and final objective was to debate for the first time about ME/CFS as a sequela of post-SARS-CoV-2 infections. The graphical summary of all the contributions received is shown in Figure 1.
Old and new viral triggers for ME/CFS:
- herpesviruses
- enteroviruses
- Ross River virus, which is an arbovirus endemic to Australia, Papua New Guinea, and other islands in the South Pacific
- herpesviruses in patients from the United Kingdom ME/CFS biobank
- SARS-CoV and SARS-CoV-2
Other studies published elsewhere provide further evidence that some long-COVID patients suffer from ME/CFS and, as such, there is a window of opportunity to improve the understanding of both conditions.
New perspectives on disease pathology and treatment
- the same “vicious circle” between inflammation, oxidative and nitrosative stress, and low thyroid hormone function is operating in both some ME/CFS and patients in an intensive care unit (ICU)
- pre-disease and early disease call for rehabilitation strategies that could avoid long-term co-morbidity while the management of the established disease should be more holistic and tailored to the specific needs of each patient
- vascular abnormalities in ME/CFS – endothelial dysfunction
- endothelial dysfunction and inadequate regulation of blood flow resulting in hypoperfusion of the brain and muscles
- autoantibodies directed against vasoregulatory receptors contribute to the vascular dysregulation in ME/CFS
- target autoreactive B cells or autoantibodies
- the use of drugs that help regulating vascular function is another possibility to treat patients with ME/CFS.
Conclusions
In conclusion, this Research Topic collects further pieces of evidence about how various viruses including SARS-CoV-2 can trigger ME/CFS. The neglect of research in ME/CFS during the last decades has left patients, carers, and clinicians alike adrift without a licensed drug to use in the disease.
On the one hand, the COVID-19 pandemic will result in an unprecedented explosion of ME/CFS cases. At the same time, this pandemic is the perfect storm that can motivate different stakeholders, including funders and clinicians, to take the necessary steps to accelerate research on ME/CFS and other post-infectious syndromes. If taken, these steps will bring hope to all those outstanding patients who have been homebound or even bedridden for many years but neglected by national health authorities.
