Clinical Characteristics of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Diagnosed in Patients with Long COVID, 2022, Tokumasu et al

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Abstract

Background and Objectives:

COVID-19 can be serious not only in the acute phase but also after the acute phase and some patients develop ME/CFS. There have been few studies on patients with long COVID in whom ME/CFS was diagnosed by physicians based on standardized criteria after examinations and exclusion diagnosis and not based on only subjective symptoms.
The purpose of this study was to elucidate the detailed characteristics of ME/CFS in patients with long COVID.

Materials and Methods:

A retrospective descriptive study was performed for patients who visited a COVID-19 aftercare clinic established in Okayama University Hospital during the period was from February 2021 to April 2022.

Results:
Clinical data were obtained from medical records for 281 patients, and 279 patients who met the definition of long COVID were included. The overall prevalence rate of ME/CFS diagnosed by three sets of ME/CFS criteria (Fukuda, Canadian and IOM criteria) was 16.8% (48.9% in male and 51.1% in females). The most frequent symptoms in ME/CFS patients were general fatigue and post-exertional malaise (89.4% of the patients), headache (34.0%), insomnia (23.4%), dysosmia (21.3%) and dysgeusia (19.1%). Dizziness, chest pain, insomnia and headache were characteristic symptoms related to ME/CFS. The male to female ratio in ME/CFS patients was equal in the present study, although ME/CFS was generally more common in women in previous studies. Given that patients with ME/CFS had more severe conditions in the acute phase of COVID-19, the severity of the acute infectious state might be involved in the pathophysiology of ME/CFS.

Conclusion:
The prevalence rate of ME/CFS and the characteristic sequelae in the long COVID condition were revealed in this study.

https://www.mdpi.com/1648-9144/58/7/850

 

The authors don’t mention that, out of the 279 Long COVID patients in their sample, only 46 have been sick longer than 6 months. These studies need to only include patients sick longer than 6 months for them to be of any use.

 

Agreed. It's also strange that they used the Fukuda criteria, which is outdated because it doesn't require PEM.

 

"The percentages of patients meeting the three sets of criteria were 17.2% for Fukuda Criteria, 17.9% for CCC, and 17.9% for IOM criteria"

"The upper panel of Figure 2 shows the total number of complaints in post COVID-19 (n = 279). The symptoms of long COVID were varied in more than 10 symptoms, and the most frequent symptoms were general fatigue and PEM (146 patients, 52.3%), dysgeusia (90 patients, 32.3%), dysosmia (86 patients, 30.8%) and headache (55 patients, 19.7%). The lower panel of Figure 2 shows symptom-based percentages of patients with ME/CFS. The most frequent symptom in ME/CFS patients was dizziness. Eight (44%) of 18 long COVID patients who complained of dizziness met the ME/CFS criteria. Other symptoms were chest pain (in 15 patients including 5 patients with ME/CFS (33.3%)), insomnia (in 37 patients including 11 patients with ME/CFS (29.7%)), headache (in 55 patients including 16 patients with ME/CFS (29.1%)), and general fatigue and PEM (in 146 patients including 42 patients with ME/CFS (28.8%))."

Figure 2