Analysis of post COVID-19 condition and its overlap with myalgic encephalomyelitis/chronic fatigue syndrome

Olga A Sukocheva, Rebekah Maksoud, Narasimha M Beeraka, SabbaRao V Madhunapantula, Mikhail Sinelnikov, Vladimir N Nikolenko, Margarita E Neganova, Sergey G Klochkov, Mohammad Amjad Kamal, Donald R Staines, Sonya Marshall-Gradisnik, Olga A Sukocheva, Rebekah Maksoud, Narasimha M Beeraka, SabbaRao V Madhunapantula, Mikhail Sinelnikov, Vladimir N Nikolenko, Margarita E Neganova, Sergey G Klochkov, Mohammad Amjad Kamal, Donald R Staines, Sonya Marshall-Gradisnik

Abstract

Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19) triggers the development of numerous pathologies and infection-linked complications and exacerbates existing pathologies in nearly all body systems. Aside from the primarily targeted respiratory organs, adverse SARS-CoV-2 effects were observed in nervous, cardiovascular, gastrointestinal/metabolic, immune, and other systems in COVID-19 survivors. Long-term effects of this viral infection have been recently observed and represent distressing sequelae recognised by the World Health Organisation (WHO) as a distinct clinical entity defined as post-COVID-19 condition. Considering the pandemic is still ongoing, more time is required to confirm post COVID-19 condition diagnosis in the COVID-19 infected cohorts, although many reported post COVID-19 symptoms overlap with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Aims of review: In this study, COVID-19 clinical presentation and associated post-infection sequelae (post-COVID-19 condition) were reviewed and compared with ME/CFS symptomatology.

Key scientific concepts of review: The onset, progression, and symptom profile of post COVID-19 condition patients have considerable overlap with ME/CFS. Considering the large scope and range of pro-inflammatory effects of this virus, it is reasonable to expect development of post COVID-19 clinical complications in a proportion of the affected population. There are reports of a later debilitating syndrome onset three months post COVID-19 infection (often described as long-COVID-19), marked by the presence of fatigue, headache, cognitive dysfunction, post-exertional malaise, orthostatic intolerance, and dyspnoea. Acute inflammation, oxidative stress, and increased levels of interleukin-6 (IL-6) and tumor necrosis factor α (TNFα), have been reported in SARS-CoV-2 infected patients. Longitudinal monitoring of post COVID-19 patients is warranted to understand the long-term effects of SARS-CoV-2 infection and the pathomechanism of post COVID-19 condition.

Keywords: Chronic fatigue syndrome; Coronavirus; Fatigue; Myalgic encephalomyelitis; Post COVID-19 condition; Post-infection; SARS-CoV-2; Sequelae.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2022. Production and hosting by Elsevier B.V.

Figures

Graphical abstract
Graphical abstract
Fig. 1
Fig. 1
SARS-CoV-2 induces multiple organ failure. Viral particles and associated cytokines (“cytokine storm”) provoke development of long-lasting complications, including chronic fatigue.
Fig. 2
Fig. 2
Immune system responses to SARS-CoV-2 and associated complications. Red arrows indicate abnormal or dysfunctional signalling associated with severity of COVID-19. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

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