Review ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature - Komaroff, Lipkin, 2023

Kalliope

Kalliope

Senior Member (Voting Rights)
Review article: ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature

Some patients remain unwell for months after “recovering” from acute COVID-19. They develop persistent fatigue, cognitive problems, headaches, disrupted sleep, myalgias and arthralgias, post-exertional malaise, orthostatic intolerance and other symptoms that greatly interfere with their ability to function and that can leave some people housebound and disabled.

The illness (Long COVID) is similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as well as to persisting illnesses that can follow a wide variety of other infectious agents and following major traumatic injury.

Together, these illnesses are projected to cost the U.S. trillions of dollars. In this review, we first compare the symptoms of ME/CFS and Long COVID, noting the considerable similarities and the few differences.

We then compare in extensive detail the underlying pathophysiology of these two conditions, focusing on abnormalities of the central and autonomic nervous system, lungs, heart, vasculature, immune system, gut microbiome, energy metabolism and redox balance.

This comparison highlights how strong the evidence is for each abnormality, in each illness, and helps to set priorities for future investigation.

The review provides a current road map to the extensive literature on the underlying biology of both illnesses.
 
Leaving the medical stuff to those who understand it, but the description of the illness is certainly bang on, and one word in this line stands out for me: Some people remain able to fulfill their main responsibilities at work and at home, although hobbled.

“Hobbled” nails it.
 
All-in-all, pretty good. About time.

But the post-infection/post-injury section, towards the end, with its reference to a "hunkering down" mechanism, left me scratching my head and feeling concerned - almost as if we'd played a good game, but ended with an own goal.
 
duncan said:
All-in-all, pretty good. About time.

But the post-infection/post-injury section, towards the end, with its reference to a "hunkering down" mechanism, left me scratching my head and feeling concerned - almost as if we'd played a good game, but ended with an own goal.
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Dauer, hibernation and torpor all involve “abnormal” innate immune responses, redox imbalance, increased glycolysis, decreased aerobic respiration, and possibly even alteration in the organisms’ microbiome. They also involve orchestration by the autonomic nervous system (and its counterparts in the nervous systems of more primitive organisms). Thus, these well-recognized “hunkering down” mechanisms all exhibit similarities to the emerging pathophysiology of ME/CFS and Long COVID, as summarized in this review.
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Yes, connecting the pathology of ME to hibernation is only a guess.
 
Why Can’t Anthony Komaroff Stop Harming ME/CFS Patients?
Breaking News for ME/CFS patients: You’re not sick, you’re “hunkering down”

During the first half of 2023, veteran ME/CFS researcher Anthony Komaroff at the Harvard School of Medicine was senior author on two publications that not only did nothing to clarify anything about the syndrome, but also injected more uncertainty, blurring the edges between ME/CFS and other conditions, and did nothing to help patients.
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Why Can’t Anthony Komaroff Stop Harming ME/CFS Patients? (substack.com)
 
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