https://www.bbc.com/future/article/20210609-how-long-will-long-covid-last I don't think this has been posted yet. Apologies if I missed it. Reasonably good piece. Quite a few mentions of ME/CFS and speculation about the overlap and what's driving the illnesses.
Here are the parts where ME is mentioned: Amy Proal, a microbiologist who runs the PolyBio Research Foundation, which studies the causes of chronic inflammatory diseases, believes that small amounts of pathogens that linger beyond the reach of the immune system in remote pockets of the body, known as reservoirs or anatomical sanctuaries, are at least partially responsible for a whole range of post-infectious syndromes. This includes long Covid, but also a number of mysterious illnesses which have puzzled scientists for decades, such as chronic Lyme disease, and also ME/CFS, a condition which has long been speculated to have infectious origins although some scientists feel there could be a range of potential causes, and bears a number of similarities to long Covid. ... Heightman says that 66% of the UCLH clinic's patients are female, and similar gender skews have been reported in ME/CFS. Women are also known to be more vulnerable to developing autoimmune diseases. The PRLC are currently working with a number of research groups to identify long Covid patients with autoantibodies – antibodies that attack their own proteins – which could be driving some of their symptoms. ... This kind of memory loss and confusion is often seen in ME/CFS, and over the past eight years scientists researching the illness have come to the conclusion that one of the key underlying causes is neuroinflammation, driven by immune cells in the brain called microglia. In healthy individuals, microglia play a key role in keeping the brain's neurons functioning normally, but they are vulnerable to disruption. Surges of inflammation in the bloodstream, either from an autoimmune reaction triggered by an infection, or the lingering presence of a virus, can cause these cells to pump out their own inflammatory molecules, which then disperse rapidly through the brain. Imaging studies conducted by Japanese scientists have revealed chronic neuroinflammation in a number of ME/CFS patients, while similar microglial disruption is thought to occur in a number of psychiatric disorders like depression and schizophrenia. ... David Kaufman, a ME/CFS doctor who has treated around 1,000 patients in Mountain View, California, over the last eight years, feels that long Covid clinicians should also look for evidence of dysfunction in the microbiome, which could be making these patients more vulnerable to suffering long-term problems from the SARS-CoV-2 virus. While ME/CFS is often regarded as an illness where sufferers rarely get better, Kaufman has an unusually high success rate, declaring that 15-20% of his patients have made a full recovery, although this claim is purely anecdotal. He says that this is in part this is due to his persistence in looking for and treating signs of a leaky gut an increased permeability of the intestinal lining, which is thought to make genetically susceptible people more prone to developing autoimmune conditions in response to an external trigger, such as a viral infection. This is because the gut is allowing toxins and bacteria to enter the bloodstream, causing a range of underlying issues from chronic inflammation to mast cell activation syndrome – a condition which typically occurs during an allergic reaction. These can be further exacerbated by a subsequent infection. "80% of the ME/CFS patients I've tested have small intestinal bacteria overgrowth, otherwise as a leaky gut," Kaufman says. "Because the gut is a major immune organ, this leads them down a road to autoimmune problems."
