Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systemic Review and Comparison of Clinical Presentation and Symptomatology

Abstract

Background and Objectives: Long COVID defines a series of chronic symptoms that patients may experience after resolution of acute COVID-19. Early reports from studies with patients with long COVID suggests a constellation of symptoms with similarities to another chronic medical illness—myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). A review study comparing and contrasting ME/CFS with reported symptoms of long COVID may yield mutualistic insight into the characterization and management of both conditions. Materials and Methods: A systemic literature search was conducted in MEDLINE and PsycInfo through to 31 January 2021 for studies related to long COVID symptomatology. The literature search was conducted in accordance with PRISMA methodology. Results: Twenty-one studies were included in the qualitative analysis. Long COVID symptoms reported by the included studies were compared to a list of ME/CFS symptoms compiled from multiple case definitions. Twenty-five out of 29 known ME/CFS symptoms were reported by at least one selected long COVID study. Conclusions: Early studies into long COVID symptomatology suggest many overlaps with clinical presentation of ME/CFS. The need for monitoring and treatment for patients post-COVID is evident. Advancements and standardization of long COVID research methodologies would improve the quality of future research, and may allow further investigations into the similarities and differences between long COVID and ME/CFS.

Long covid—mechanisms, risk factors, and management

“…Post-COVID-19 fatigue has been compared with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), with many overlaps between the two. 72 Symptoms common to both ME/CFS and long covid include fatigue, neurological/pain, neurocognitive/ psychiatric, neuroendocrine, autonomic, and immune symptoms, with both ME/CFS and long covid patients having long symptom durations, reduced daily activity, and post-exertional malaise. 72 ME/CFS remains enigmatic, therefore, research into long covid may assist in developing understanding of ME/CFS and vice versa.…”

Chronic fatigue and post-exertional malaise in people living with long COVID

“…Healthcare professionals who are living with long COVID describe its trajectory as unpredictable, episodic and having a relapse-remitting nature [12][13][14]. Reports of persistent fatigue alongside fluctuating symptoms that worsen unpredictably or in response to exertion have led to comparisons between long COVID and other post-viral conditions, including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) [5,6,[15][16][17]. One of the hallmark symptoms of ME/CFS is post-exertional symptom exacerbation, also called post-exertional malaise (PEM) [18,19].…”

Clinical Heterogeneity in ME/CFS. A Way to Understand Long-COVID19 Fatigue

“…In the current context of SARS Cov2 pandemic, the clinical status of Long COVID19 emerges (43) reporting fatigue, postexertional malaise (PEM), cognitive problems (brain fog), etc. Various authors are orienting their reviews toward ME/CFS (44) looking indications for the future challenges (45). Patients with Long COVID19 can also be evaluated with our proposed battery of probes.…”