Review POTS, ME/CFS and Long COVID as Neuroimmune Disorders, 2026, Blitshteyn et al

John Mac

Senior Member (Voting Rights)
Full title: Postural Orthostatic Tachycardia Syndrome, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID as Neuroimmune Disorders

Abstract:
Postural orthostatic tachycardia syndrome (POTS), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID are heterogeneous disorders with overlapping complex, multi-factorial and multi-systemic pathophysiology.

POTS and ME/CFS are the most common phenotypes of Long COVID that can lead to significant disability and functional impairment. The exact pathophysiologic mechanisms of these disorders alone or in combination are still being investigated, but important mechanistic factors have been identified, such as autonomic dysfunction, immune dysregulation, autoimmunity, mitochondrial dysfunction, cerebral hypoperfusion, and neuroinflammation.

To this end, we believe that these conditions should be viewed as neuroimmune disorders and should be included in the field of neuroimmunology, with its educational curriculum, training, and clinical care pathways. Including these disorders as part of neuroimmunology subspecialty is the key to advancing the science and clinical care of this underserved patient population with these complex and disabling conditions.



 

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Just plain wrong again, unsurprisingly


Svetlana disagrees.



Hot off the press: my new paper that moves this field forward and changes the narrative on what #POTS, #MECFS and #LongCOVID are... Neuroimmune Disorders!

The brain and the autonomic nervous system are involved in the immune system regulation.
There is evidence of autoimmunity, immune dysregulation, cerebral hypoperfusion, neuroinflammation and other mechanisms in all three disorders.
#Neuroimmunology is a field that should embrace these disorders: #MultipleSclerosis, the staple of neuroimmunology, used to be called hysterical paralysis before CT and MRI were invented. We're at the same crossroads with these disorders.
❌ These disorders are not "mysterious", "anxiety", "deconditioning," "functional neurologic" etc. etc.
‼️ Classifying these disorders as neuroimmune and including them as part of neuroimmunology training is critical.
#PatientCare and lives of millions of people living with these disabling conditions are at stake!

Thanks to my esteemed colleagues and co-authors, Dr. @TaylorDoherty8, immunologist from UC San Diego and Dr. Lawrence Steinman, neuroimmunologist from @StanfordMed, for their support!
 
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