"Long COVID and Chronic Fatigue Syndrome Share Pathophysiology" by Anthony L. Komaroff, MD (NEJM Journal Watch)

[Tom Kindlon]

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June 15, 2023

Long COVID and Chronic Fatigue Syndrome Share Pathophysiology
Anthony L. Komaroff, MD

Similar neurological, immunological, metabolic, and cardiopulmonary abnormalities are present.


Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — the illness originally called just “chronic fatigue syndrome” — often begins suddenly in young, healthy adults following what seems, at first, to be a transient “flu-like” illness. However, patients are left with symptoms that persist for years (Mayo Clin Proc 2021; 96:2861. opens in new tab).

When interest in ME/CFS surged in the mid-1980s, it was uncertain if any underlying biological abnormalities existed that could explain the patients' symptoms. Indeed, most standard clinical laboratory test results were normal. This led skeptics to suspect that patients were suffering from depression or somatization or even that they were fabricating their symptoms to achieve some secondary goal. By 2020, however, thousands of published scientific studies had identified multiple abnormalities, many National Institutes of Health (NIH) conferences had been dedicated to ME/CFS, and research on the illness was underway at laboratories around the world.

Continues at:
https://www.jwatch.org/na56219/2023...ic-fatigue-syndrome-share?query=etoc_jwgenmed

 

[Andy]

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — the illness originally called just “chronic fatigue syndrome”

Err, no. As we all know, the illness originally called just "myalgic encephalomyelitis".

 

[Hoopoe]

"ME/CFS" is the new name for CFS and for ME. CFS was the new name for ME.

 

[SNT Gatchaman]

Why would multiple different infectious agents and major physical trauma produce a similar syndrome? One hypothesis is that this syndrome is driven by an evolutionarily preserved protective response, the goal of which is to change an animal's behavior. The symptoms — fatigue, “brain fog,” and anorexia — discourage activities that consume energy (ATP), like movement, thinking, and digesting. This frees up available supplies of ATP for the fight against infection or injury. For some reason, in some patients, either this protective response is not turned off when the infection is eradicated and the injury is healed, or some ongoing inflammation in the body continually signals the brain that the battle is not over.

I would have preferred this paragraph to have been cut. Why mention only this hypothesis and not others? It's not a very good one at that. "Brain fog" as an evolutionarily preserved advantage? Not turned off when the infection is eradicated? I don't think so. Do people routinely get brain fog with everyday viral illnesses as part of the anorexia/nausea etc sickness response? I've never experienced it with ME/LC or prior (and I had a week-long spanking from — I'm pretty sure — Swine flu in 2009). People with ME and autoimmune conditions etc, and those having chemotherapy describe a very clear and profound form of temporary cognitive impairment.

 

[Andy]

"ME/CFS" is the new name for CFS and ME so he's right.

No he's not. He identifies it as a singular illness, i.e. CFS and ME are the same thing, therefore the illness was first called myalgic encephalomyelitis, and was then called chronic fatigue syndrome, and is now called ME/CFS.

 

[DokaGirl]

Err, no. As we all know, the illness originally called just "myalgic encephalomyelitis".

 

[DokaGirl]

Speaking from my own experience, and understanding of what went on with the two names: Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS), first the term used for the disease defined by Dr. Melvin Ramsay, was Myalgic Encephalomyelitis.

Then for political, and financial reasons came the watered down case definitions, and this very debilitating illness was given the down graded, vague, and pejorative name Chronic Fatugue Syndrome. Which everyone, unaware of the terrible consequences of this disease can laughingly say they have.

This name change blurred the borders of this distinct, very debilitating disease, and made it disappear as a biomedical entity, which continues to save governments and the insurance industry a great deal of money. As well as generate a money maker for the BPS Movement.

It is also my understanding that the combo name ME/CFS has been an effort by well-intentioned experts to indicate that those labeled with CFS actually have the serious biomedical disease ME. There may also be the intention that this combo name will help swing the pendulum back to the original name: ME.

In my own experience, my first label was CFS. However, my symptoms, and severity of illness far exceed the downgraded/vague versions of CFS. My symptoms match those described in the Canadian Consensus Criteria, as well as the International Consensus Criteria of ME.