Review Post Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current knowledge and Future Directions, 2023, Tackey

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Review Article
Post Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current knowledge and Future Directions
Caleb Tackey
P. Maxwell Slepian
Hance Clarke
&
Nimish Mittal
Article: 2272999 | Received 06 Apr 2023, Accepted 16 Oct 2023, Accepted author version posted online: 03 Nov 2023

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• https://doi.org/10.1080/24740527.2023.2272999
  

ABSTRACT

Post-viral pain syndrome, also known as post-viral syndrome (PVS), is a complex condition characterized by persistent pain, fatigue, musculoskeletal pain, neuropathic pain, neurocognitive difficulties, and sleep disturbances1,2 that can occur after an individual has recovered from a viral infection.

Much remains unknown regarding the pathophysiology of post-viral syndromes and few studies have provided a comprehensive summary of the condition, agents that cause it, and successful treatment modalities.

With the COVID-19 pandemic continuing to affect millions of people worldwide, the need for understanding the etiology of post-viral illness and how to help individuals cope with the sequalae is paramount.2

This narrative review provides a summary of the sequelae of post-viral syndromes, viral agents that cause it, the pathophysiology, treatment, and future considerations for research and targeted therapies.

 

Manages to avoid talking about ME/CFS as much as possible while still talking about "post-viral fatigue"

"2.3. Diagnosis and treatment of post-viral fatigue

There are no agreed-upon diagnostic criteria for post-viral fatigue. The diagnosis is typically made when fatigue is preceded by a viral illness and cannot be explained by other conditions, such as anemia, adrenal insufficiency and cancer.Citation63 Similarly, there is no standardized protocol for the treatment of post-viral fatigue. Management depends on the individual patient’s illness experience and is typically focused on energy conservation.Citation64 Lifestyle modifications, such as reducing daily activity and low-intensity aerobic graduated exercise, are commonly prescribed. Cognitive behavioural therapy (CBT) has also been suggested.Citation65 Indeed, a recent trial of CBT for management of fatigue in Post-COVID syndrome found a medium effect size improvement in fatigue over treatment as usual, which was maintained six months after treatment.Citation66 Autonomic dysregulation (POTS and OH) is a major contributor of fatigue post viral infection and should be evaluated in individuals suffering from fatigue in PVS. Treatment of POTS/OH with pharmacological (e.g. propranolol, ivabradine, midodrine) and non-pharmacological measures including graduated aerobic activity with mild resistance training can help alleviate fatigue symptoms.Citation67 One case report from England demonstrated the successful use of electroacupuncture in a patient who experienced post-viral fatigue following an “influenza-like” illness,Citation68 although larger-scale studies have not evaluated its efficacy and the case report was anecdotal."

Citations
63 - Fatigue as the Chief Complaint: Epidemiology, Causes, Diagnosis, and Treatment 2021 Maisel et al
64 - Patient management of post-viral fatigue syndrome, 1990, Ho-Yen, https://pubmed.ncbi.nlm.nih.gov/2107839/
65 - Management of chronic (post-viral) fatigue syndrome, 1989, Wesselly, David, Butler, Chalder, https://pubmed.ncbi.nlm.nih.gov/2553945/
66 - Efficacy of cognitive behavioral therapy targeting severe fatigue following COVID-19: results of a randomized controlled trial 2023, Kuut, Knoop et al
67 - Diagnosis and management of postural orthostatic tachycardia syndrome, 2022, Satish et al, https://www.cmaj.ca/content/194/10/E378
68 - Acupuncture in the Treatment of Post Viral Fatigue Syndrome – a Case Report, 2005, Mears, https://journals.sagepub.com/doi/10.1136/aim.23.3.141

The title of this paper claims that it presents current knowledge, while referencing papers over 30 years old....

 

First sentence of the abstract slips into assumption with the unequivocal "has recovered".