COVID-19 and post-infectious myalgic encephalomyelitis/chronic fatigue syndrome: a narrative review

Sonia Poenaru, Sara J Abdallah, Vicente Corrales-Medina, Juthaporn Cowan, Sonia Poenaru, Sara J Abdallah, Vicente Corrales-Medina, Juthaporn Cowan

Abstract

Coronavirus disease 2019 (COVID-19) is a viral infection which can cause a variety of respiratory, gastrointestinal, and vascular symptoms. The acute illness phase generally lasts no more than 2-3 weeks. However, there is increasing evidence that a proportion of COVID-19 patients experience a prolonged convalescence and continue to have symptoms lasting several months after the initial infection. A variety of chronic symptoms have been reported including fatigue, dyspnea, myalgia, exercise intolerance, sleep disturbances, difficulty concentrating, anxiety, fever, headache, malaise, and vertigo. These symptoms are similar to those seen in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a chronic multi-system illness characterized by profound fatigue, sleep disturbances, neurocognitive changes, orthostatic intolerance, and post-exertional malaise. ME/CFS symptoms are exacerbated by exercise or stress and occur in the absence of any significant clinical or laboratory findings. The pathology of ME/CFS is not known: it is thought to be multifactorial, resulting from the dysregulation of multiple systems in response to a particular trigger. Although not exclusively considered a post-infectious entity, ME/CFS has been associated with several infectious agents including Epstein-Barr Virus, Q fever, influenza, and other coronaviruses. There are important similarities between post-acute COVID-19 symptoms and ME/CFS. However, there is currently insufficient evidence to establish COVID-19 as an infectious trigger for ME/CFS. Further research is required to determine the natural history of this condition, as well as to define risk factors, prevalence, and possible interventional strategies.

Keywords: COVID-19; chronic fatigue syndrome; human coronavirus; myalgic encephalomyelitis; post-infectious fatigue; review.

Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

© The Author(s), 2021.

Figures

Figure 1.
Figure 1.
Summary of post-infectious ME/CFS mechanisms. Infective agents activate and alter immune system function leading to chronic inflammation, increased pro-inflammatory cytokine signaling, and abnormal function of multiple cell types including Th1, Th17, T-regulatory, and natural killer cells. Autoimmune mechanisms such as molecular mimicry and auto-reactive bystander cell activation can also be triggered during acute infection. Infective agents with neuro-invasive potential can cause inflammatory and ischemic damage to central nervous system cells and tissues, resulting in neuronal degeneration, demyelination, and subsequent functional impairment. Infective agents may also cause structural damage to mitochondria, leading to decreased energy production, altered metabolism, and reduced anti-oxidant function. These processes may underlie the symptoms reported in post-infectious ME/CFS.

References

    1. del Rio C, Collins LF, Malani P. Long-term health consequences of COVID-19. JAMA 2020; 324: 1723.
    1. Greenhalgh T, Knight M, A’Court C, et al.. Management of post-acute covid-19 in primary care. BMJ 2020; 370: m3026.
    1. Garner P. Covid-19 at 14 weeks—phantom speed cameras, unknown limits, and harsh penalties. BMJ Opinion, . (2020, accessed 25 October 2020).
    1. Ladds E, Rushforth A, Wieringa S, et al.. Persistent symptoms after COVID-19: qualitative study of 114 “long COVID” patients and draft quality criteria for services. J Infect Dis. Epub ahead of print 14 October 2020. DOI: 10.1101/2020.10.13.20211854.
    1. Michelen M, Manoharan L, Elkheir N, et al.. Characterising long-term covid-19: a rapid living systematic review. Glob Public Health. Epub ahead of print 9 December 2020. DOI: 10.1101/2020.12.08.20246025.
    1. Lim EJ, Ahn YC, Jang ES, et al.. Systematic review and meta-analysis of the prevalence of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). J Transl Med 2020; 18: 100.
    1. Jason LA, Porter N, Brown M, et al.. CFS: a review of epidemiology and natural history studies. Bull IACFS ME 2009; 17: 88–106.
    1. Prins JB, van der Meer JW, Bleijenberg G. Chronic fatigue syndrome. Lancet 2006; 367: 346–355.
    1. Naess H, Sundal E, Myhr K-M, et al.. Postinfectious and chronic fatigue syndromes: clinical experience from a tertiary-referral centre in Norway. In Vivo 2010; 24: 185–188.
    1. Hatcher S, House A. Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case–control study. Psychol Med 2003; 33: 1185–1192.
    1. Theorell T, Blomkvist V, Lindh G, et al.. Critical life events, infections, and symptoms during the year preceding Chronic Fatigue Syndrome (CFS): an examination of CFS patients and subjects with a nonspecific life crisis. Psychosom Med 1999; 61: 304–310.
    1. Demitrack MA, Greden JF. Chronic fatigue syndrome: the need for an integrative approach. Biol Psychiatry 1991; 30: 747–752.
    1. Clayton EW. Beyond myalgic encephalomyelitis/chronic fatigue syndrome: an IOM report on redefining an illness. JAMA 2015; 313: 1101–1102.
    1. Holmes GP. Chronic fatigue syndrome: a working case definition. Ann Intern Med 1988; 108: 387–389.
    1. Carruthers BM, van de Sande MI, De Meirleir KL, et al.. Myalgic encephalomyelitis: International Consensus Criteria. J Intern Med 2011; 270: 327–338.
    1. Fukuda K, Straus SE, Hickie I, et al.. The chronic fatigue syndrome: a comprehensive approach to its definition and study. 1994; 121: 953–959.
    1. Lim EJ, Son CG. Review of case definitions for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). J Transl Med 2020; 18: 289.
    1. Jason LA, Kot B, Sunnquist M, et al.. Chronic fatigue syndrome and myalgic encephalomyelitis: towards an empirical case definition. Health Psychol Behav Med 2015; 3: 82–93.
    1. Carruthers BM, Jain AK, De Meirleir KL, et al.. Myalgic encephalomyelitis/chronic fatigue syndrome: a clinical case definition and guidelines for medical practitioners (an overview of the Canadian consensus document). J Chronic Fatigue Syndr 2003; 11: 7–115.
    1. Maksoud R, du Preez S, Eaton-Fitch N, et al.. A systematic review of neurological impairments in myalgic encephalomyelitis/chronic fatigue syndrome using neuroimaging techniques. PLoS One 2020; 15: e0232475.
    1. Brown AA, Jason LA. Validating a measure of myalgic encephalomyelitis/chronic fatigue syndrome symptomatology. Fatigue 2014; 2: 132–152.
    1. Lyons D, Frampton M, Naqvi S, et al.. Fallout from the COVID-19 pandemic – should we prepare for a tsunami of post viral depression? Ir J Psychol Med 2020; 37: 1–6.
    1. Briggs NC, Levine PH. A comparative review of systemic and neurological symptomatology in 12 outbreaks collectively described as chronic fatigue syndrome, epidemic neuromyasthenia, and myalgic encephalomyelitis. Clin Infect Dis 1994; 18(Suppl. 1): S32–S42.
    1. Levine PH, Dale JK, Benson-Grigg E, et al.. A cluster of cases of chronic fatigue and chronic fatigue syndrome: clinical and immunologic studies. Clin Infect Dis 1996; 23: 408–409.
    1. Islam MF, Cotler J, Jason LA. Post-viral fatigue and COVID-19: lessons from past epidemics. Fatigue 2020; 8: 61–69.
    1. Radusin M. The Spanish flu – part II: the second and third wave. Vojnosanit Pregl 2012; 69: 917–927.
    1. Katz BZ, Shiraishi Y, Mears CJ, et al.. Chronic fatigue syndrome after infectious mononucleosis in adolescents. Pediatrics 2009; 124: 189–193.
    1. Hickie I, Davenport T, Wakefield D, et al.. Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study. BMJ 2006; 333: 575.
    1. Buchwald DS, Rea TD, Katon WJ, et al.. Acute infectious mononucleosis: characteristics of patients who report failure to recover. Am J Med 2000; 109: 531–537.
    1. Garcia MN, Hause AM, Walker CM, et al.. Evaluation of prolonged fatigue post–West Nile virus infection and association of fatigue with elevated antiviral and proinflammatory cytokines. Viral Immunol 2014; 27: 327–333.
    1. White PD, Thomas JM, Amess J, et al.. Incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever. Br J Psychiatry 1998; 173: 475–481.
    1. Cope H. Predictors of chronic ‘postviral’ fatigue. Lancet 1994; 344: 864–868.
    1. Magnus P, Gunnes N, Tveito K, et al.. Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine. Vaccine 2015; 33: 6173–6177.
    1. Ahmed H, Patel K, Greenwood D, et al.. Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: a systematic review and meta-analysis. J Rehabil Med 2020; 52: jrm00063.
    1. Rogers JP, Chesney E, Oliver D, et al.. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 2020; 7: 611–627.
    1. Lam MHB. Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up. Arch Intern Med 2009; 169: 2142–2147.
    1. Moldofsky H, Patcai J. Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome: a case-controlled study. BMC Neurol 2011; 11: 37.
    1. Tansey CM. One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome. Arch Intern Med 2007; 167: 1312–1320.
    1. Bornand D, Toovey S, Jick SS, et al.. The risk of new onset depression in association with influenza – a population-based observational study. Brain Behav Immun 2016; 53: 131–137.
    1. Luyt C-E, Combes A, Becquemin M-H, et al.. Long-term outcomes of pandemic 2009 influenza A(H1N1)-associated severe ARDS. Chest 2012; 142: 583–592.
    1. Chen J, Wu J, Hao S, et al.. Long term outcomes in survivors of epidemic Influenza A (H7N9) virus infection. Sci Rep 2017; 7: 17275.
    1. Kim H-C, Yoo S-Y, Lee B-H, et al.. Psychiatric findings in suspected and confirmed Middle East respiratory syndrome patients quarantined in hospital: a retrospective chart analysis. Psychiatry Investig 2018; 15: 355–360.
    1. Mak IWC. Long-term psychiatric morbidities among SARS survivors. Gen Hosp Psychiatry 2009; 10: 318–326.
    1. Rasa S, Nora-Krukle Z, Henning N, et al.. Chronic viral infections in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). J Transl Med 2018; 16: 268.
    1. Wu Y, Xu X, Chen Z, et al.. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun 2020; 87: 18–22.
    1. Li Y, Fu L, Gonzales DM, et al.. Coronavirus neurovirulence correlates with the ability of the virus to induce proinflammatory cytokine signals from astrocytes and microglia. J Virol 2004; 78: 3398–3406.
    1. Broderick G, Fuite J, Kreitz A, et al.. A formal analysis of cytokine networks in chronic fatigue syndrome. Brain Behav Immun 2010; 24: 1209–1217.
    1. Almqvist J, Granberg T, Tzortzakakis A, et al.. Neurological manifestations of coronavirus infections – a systematic review. Ann Clin Transl Neurol 2020; 7: 2057–2071.
    1. Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun 2020; 87: 34–39.
    1. Strawbridge R, Sartor M-L, Scott F, et al.. Inflammatory proteins are altered in chronic fatigue syndrome—a systematic review and meta-analysis. Neurosci Biobehav Rev 2019; 107: 69–83.
    1. Corbitt M, Eaton-Fitch N, Staines D, et al.. A systematic review of cytokines in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis/Systemic Exertion Intolerance Disease (CFS/ME/SEID). BMC Neurol 2019; 19: 207.
    1. Anderson G, Maes M. Mitochondria and immunity in chronic fatigue syndrome. Prog Neuropsychopharmacol Biol Psychiatry 2020; 103: 109976.
    1. Piraino B, Vollmer-Conna U, Lloyd AR. Genetic associations of fatigue and other symptom domains of the acute sickness response to infection. Brain Behav Immun 2012; 26: 552–558.
    1. Vollmer-Conna U, Piraino BF, Cameron B, et al.. Cytokine polymorphisms have a synergistic effect on severity of the acute sickness response to infection. Clin Infect Dis 2008; 47: 1418–1425.
    1. Woodruff MC, Ramonell RP, Lee FEH, et al.. Clinically identifiable autoreactivity is common in severe SARS-CoV-2 infection. Infect Dis. Epub ahead of print 23 October 2020. DOI: 10.1101/2020.10.21.20216192.
    1. Mensah FKF, Bansal AS, Ford B, et al.. Chronic fatigue syndrome and the immune system: where are we now? Clin Neurophysiol 2017; 47: 131–138.
    1. Desforges M, Le Coupanec A, Dubeau P, et al.. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses 2019; 12: 14.
    1. Arbour N, Day R, Newcombe J, et al.. Neuroinvasion by human respiratory coronaviruses. J Virol 2000; 74: 8913–8921.
    1. Xu J, Zhong S, Liu J, et al.. Detection of severe acute respiratory syndrome coronavirus in the brain: potential role of the chemokine mig in pathogenesis. Clin Infect Dis 2005; 41: 1089–1096.
    1. Varatharaj A, Thomas N, Ellul MA, et al.. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry 2020; 7: 875–882.
    1. Clauw DJ, Häuser W, Cohen SP, et al.. Considering the potential for an increase in chronic pain after the COVID-19 pandemic. Pain. Epub ahead of print 26 June 2020. DOI: 10.1097/j.pain.0000000000001950.
    1. Filler K, Lyon D, Bennett J, et al.. Association of mitochondrial dysfunction and fatigue: a review of the literature. BBA Clin 2014; 1: 12–23.
    1. Behan WM, More IA, Behan PO. Mitochondrial abnormalities in the postviral fatigue syndrome. Acta Neuropathol 1991; 83: 61–65.
    1. Maes M, Twisk FNM. Why Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) may kill you: disorders in the Inflammatory and Oxidative and Nitrosative Stress (IO&NS) pathways may explain cardiovascular disorders in ME/CFS. Neuroendocrinol Lett 2009; 30: 677–693.
    1. Broderick G, Craddock RC, Whistler T, et al.. Identifying illness parameters in fatiguing syndromes using classical projection methods. Pharmacogenomics J 2006; 7: 407–419.
    1. Stevens S, Snell C, Stevens J, et al.. Cardiopulmonary exercise test methodology for assessing exertion intolerance in myalgic encephalomyelitis/chronic fatigue syndrome. Front Pediatr 2018; 6: 242.
    1. Nacul L, O’Boyle S, Palla L, et al.. How Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) progresses: the natural history of ME/CFS. Front Neurol 2020; 11: 826.
    1. Vernon SD, Whistler T, Cameron B, et al.. Preliminary evidence of mitochondrial dysfunction associated with post-infective fatigue after acute infection with Epstein Barr virus. BMC Infect Dis 2006; 6: 15.
    1. Kurup KK, Kurup PA. Isoprenoid pathway dysfunction in chronic fatigue syndrome. Acta Neuropsychiatrica 2003; 15: 266–273.
    1. Holden S, Maksoud R, Eaton-Fitch N, et al.. A systematic review of mitochondrial abnormalities in myalgic encephalomyelitis/chronic fatigue syndrome/systemic exertion intolerance disease. J Transl Med 2020; 18: 290.
    1. Huang C, Huang L, Wang Y, et al.. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. Epub ahead of print 8 January 2020. DOI: 10.1016/S0140-6736(20)32656-8.
    1. Carfi A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA 2020; 324: 603–605.
    1. Townsend L, Dyer AH, Jones K, et al.. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. Infect Dis. Epub ahead of print 20 June 2020. DOI: 10.1101/2020.07.29.20164293.
    1. Huang Y, Tan C, Wu J, et al.. Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase. Research Square. Epub ahead of print 16 June 2020. DOI: 10.21203/-26415/v2.
    1. Halpin SJ, McIvor C, Whyatt G, et al.. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J Med Virol. Epub ahead of print 30 July 2020. DOI: 10.1002/jmv.26368.
    1. Frija-Masson J, Debray MP, Gilbert M, et al.. Functional characteristics of patients with SARS-CoV-2 pneumonia at 30 days post-infection. Eur Respir J 2020; 56: 2001754.
    1. Lv D, Chen X, Mao L, et al.. Pulmonary function of patients with 2019 novel coronavirus induced pneumonia: a retrospective cohort study. Research Square. Epub ahead of print 27 April 2020. DOI: 10.21203/-24303/v1.
    1. Wang X, Xu H, Jiang H, et al.. Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study. QJM Int J Med 2020; 113: 657–665.
    1. Perrin R, Riste L, Hann M, et al.. Into the looking glass: post-viral syndrome post COVID-19. Medl Hypotheses 2020; 144: 110055.
    1. Peel M. What can we tell patients with prolonged Covid-19? BMJ 2020; 370: m2923.
    1. Salisbury H. Helen Salisbury: when will we be well again? BMJ 2020; 369: m2490.
    1. Arnold DT, Hamilton FW, Milne A, et al.. Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax. Epub ahead of print 3 December 2020. DOI: 10.1136/thoraxjnl-2020-216086.
    1. Mandal S, Barnett J, Brill SE, et al.. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. Epub ahead of print 10 November 2020. DOI: 10.1136/thoraxjnl-2020-215818.
    1. Ayoubkhani D, Khunti K, Nafilyan V, et al.. Epidemiology of post-COVID syndrome following hospitalisation with coronavirus: a retrospective cohort study. Epidemiology. Epub ahead of print 15 January 2021. DOI: 10.1101/2021.01.15.21249885.
    1. Pellaud C, Grandmaison G, Pham Huu Thien HP, et al.. Characteristics, comorbidities, 30-day outcome and in-hospital mortality of patients hospitalised with COVID-19 in a Swiss area – a retrospective cohort study. Swiss Med Wkly. Epub ahead of print 14 July 2020. DOI: 10.4414/smw.2020.20314.
    1. Xiong Q, Xu M, Li J, et al.. Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clin Microbiol Infect 2021; 27: 89–95.
    1. Jacobs LG, Gourna-Paleoudis E, Lesky-Di Bari D, et al.. Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS One 2020; 15: e0243882.
    1. Pilotto A, Cristillo V, Piccinelli SC, et al.. COVID-19 severity impacts on long-term neurological manifestation after hospitalisation. Neurology. Epub ahead of print 2 January 2021. DOI: 10.1101/2020.12.27.20248903.
    1. Nehme M, Braillard O, Alcoba G, et al.. COVID-19 symptoms: longitudinal evolution and persistence in outpatient settings. Ann Intern Med. Epub ahead of print 8 December 2020. DOI: 10.7326/M20-5926.
    1. Khalaf M, Bazeed SE, Abdel-Gawad M, et al.. Prevalence and predictors of persistent symptoms after clearance of SARS-CoV-2 infection: a report from Egypt. SSRN J. Epub ahead of print 3 December 2020. DOI: 10.2139/ssrn.3727954.
    1. Chopra V, Flanders SA, O’Malley M, et al.. Sixty-day outcomes among patients hospitalized with COVID-19. Ann Intern Med. Epub ahead of print 11 November 2020. DOI: 10.7326/M20-5661.
    1. Mohamed-Hussein A, Galal I, Saad M, et al.. Post-COVID-19 functional status: relation to age, smoking, hospitalization and comorbidities. Respir Med. Epub ahead of print 1 September 2020. DOI: 10.1101/2020.08.26.20182618.
    1. Galal I, Hussein AAM, Amin MT, et al.. Determinants of persistent post COVID-19 symptoms: value of a novel COVID-19 symptoms score. Respir Med. Epub ahead of print 12 November 2020. DOI: 10.1101/2020.11.11.20230052.
    1. Moradian ST, Parandeh A, Khalili R, et al.. Delayed symptoms in patients recovered from COVID-19. Iran J Public Health 2020; 49: 8.
    1. Petersen MS, Kristiansen MF, Hanusson KD, et al.. Long COVID in the Faroe Islands - a longitudinal study among non-hospitalized patients. Clin Infect Dis. Epub ahead of print 30 November 2020. DOI: 10.1093/cid/ciaa1792.
    1. Galván-Tejada CE, Herrera-García CF, Godina-González S, et al.. Persistence of COVID-19 symptoms after recovery in Mexican population. Int J Environ Res Public Health 2020; 17: 9367.
    1. Garrigues E, Janvier P, Kherabi Y, et al.. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect 2020; 81: e4–e6.
    1. Varghese J, Sandmann S, Vollenberg R, et al.. Follow up of COVID-19 features in recovered adults without comorbidities– persistent symptoms and lab abnormalities. Research Square. Epub ahead of print 30 November 2020. DOI: 10.21203/-116030/v1.
    1. Darley DR, Dore GJ, Cysique L, et al.. High rate of persistent symptoms up to 4 months after community and hospital-managed SARS-CoV-2 infection. J Med Aust. Epub ahead of print 3 March 2021. DOI: 10.5694/mja2.50963.
    1. Wong AW, Shah AS, Johnston JC, et al.. Patient-reported outcome measures after COVID-19: a prospective cohort study. Eur Respir J 2020; 56: 2003276.
    1. Stavem K, Ghanima W, Olsen MK, et al.. Persistent symptoms 1.5–6 months after COVID-19 in non-hospitalised subjects: a population-based cohort study. Thorax. Epub ahead of print 3 December 2020. DOI: 10.1136/thoraxjnl-2020-216377.
    1. Miyazato Y, Morioka S, Tsuzuki S, et al.. Prolonged and late-onset symptoms of coronavirus disease 2019. Open Forum Infect Dis 2020; 7: 1–3.
    1. Zhao Y-M, Shang Y-M, Song W-B, et al.. Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery. EClinicalMedicine 2020; 25: 100463.
    1. George PM, Barratt SL, Condliffe R, et al.. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax 2020; 75: 1009–1016.
    1. Larun L, Brurberg KG, Odgaard-Jensen J, et al.. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev 2019; 10: CD003200.
    1. Kim DY, Lee JS, Park SY, et al.. Systematic review of randomized controlled trials for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). J Transl Med 2020; 18: 7.
    1. Kindlon T. and Irish ME/CFS Association. Reporting of harms associated with graded exercise therapy and cognitive behavioural therapy in myalgic encephalomyelitis/chronic fatigue syndrome. Bull IACFS ME 2011; 19: 59–111.
    1. Torjesen I. NICE cautions against using graded exercise therapy for patients recovering from Covid-19. BMJ 2020; 370: m2912.
    1. Johnston S, Staines D, Marshall-Gradisnik S. Epidemiological characteristics of chronic fatigue syndrome/myalgic encephalomyelitis in Australian patients. Clin Epidemiol 2016; 8: 97–107.
    1. Ngai JC, Ko FW, Ng SS, et al.. The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology 2010; 15: 543–550.
    1. Herridge MS, Matte-Martyn A, Diaz-Granados N, et al.. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003; 348: 683–693.
    1. Cheung AM, Tansey CM, Tomlinson G, et al.. Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med 2006; 174: 538–544.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner