That looks like it. Good find:
https://reader.elsevier.com/reader/sd/pii/S0025775322001245
Unfortunately only a version in Spanish is available at the moment
Pandemic due to a pandemic?
Jordi Robert Olalla
After two years of pandemic, to the many doubts that have arisen in prevention, vaccination and treatment in the acute phase, we now have to add the doubts being generated around the understanding and classification of the complications of the infection by SARS-Cov-2.
Until now, and without absolute consensus three clinical situations have been identified, related to, or as consequences of infection by Covid-19.
The first would be the clinical manifestations consequent on damage that in different organs have been produced by the infection by Covid-19, such as the lung, also including multisystem inflammatory syndrome. The second would be the manifestations secondary to hospitalisation, admission to ICU and treatment of the infection. Without doubt, however, the form that generates most uncertainty is that called
long Covid or persistent Covid-19.
None of these excludes the others, and the same patient may be diagnosed, for example, with persistent Covid-19 with complications from prolonged admission to ICU, as in the myopathy of the critically ill.
Accepted under ‘persistent Covid-19’ is a persistent clinical pattern that can appear after infection with Covid-19, including mild or asymptomatic forms (of the acute phase). Without consensus on delayed onset, but yes, in general terms, the diagnosis is accepted if symptoms persist more than 4-12 weeks without their being explanained by an alternative diagnosis. The principal clinical manifetations are fatigue, difficulty thinking or concentrating (brain fog), orthostatic intolerance, palpitations, muscle and joint pain and headache; all the symptoms worsen with exertion. Although loss of taste is included it remains to be agreed whether this is a feature of persistent Covid-19 or a complication of the original infection.
But are we really defining a clinical entity, a new disease?
ME, also known as CFS and with the suggested name SEID has been known since 1988. Although the aetiology is unknown, historically, viral infection has been linked to the onset or development of the syndrome; special attention has been paid, without conclusive studies, to EBV, Q fever and Lyme disease. The different criteria and scales for diagnosis of CFS include physical and mental fatigue, unrefreshing sleep, orthostatic intolerance, headache, muscle pains, symptoms that limit the quality of life and ability to carry out many daily tasks, symptoms that woren with exertion that may be minimal and s=ymptoms that persist for more than six months. The diagnosis is clinical, based on exclusion of other diagnoses that might explain the symptoms.
The term fatigue merits special attention for its difficulty to be well defined. Fatigue – is it tiredness? is it debility? Just as in CFS, in persistent Covid-19 fatigue often refers to the inability to carry out daily tasks from tiredness. If the assessment is of muscle weakness the patient will need exhaustive studies to discount other cardiorespiratory or muscle diseases. Probably for such cases the term fatigue is quite inappropriate.
For those patients diagnosed with persistent Covid-19 and in those with symptoms for more than 6 months is there a difference from patients diagnosed with CFS?
Current knowledge of what is known as persistent Covid-19 may change a lot over coming months and perhapos these two questions will be definitive in the illness: are we dealing with a chronic illness that will persist or a reversible illness that is curable? And if reversible: will the cure come from the natural history of the illness or therapeutic intervention?
With answers to these questions come new questions. If we are dealing with a chronic illness are we not facing CFS linked to a viral infection, in this case Covid-19? If we are dealing with a reversible condition: will treatments used for persistent Covid-19 also be useful for CFS?
Probably, based on the data comig out in various publications, we are delaing with a persistent illness and in my opinion we may need to change the name. In this case we will be facing a massive increase in incidence and prevalence of CFS.
Perhaps out of this pandemic will emerge another pandemic, this time of an illness already known – as is CFS.