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