Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): Where will the drugs come from?

Toogood, Peter L.; Clauw, Daniel J.; Phadke, Sameer; Hoffman, Donald L.

doi:10.1016/j.phrs.2021.105465

Cited by 46 publications

(50 citation statements)

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“…There is less variability in the data in the test arm on days 8, 11 and 14 when compared to days 0 and 4 in the test arm as well as when compared to days 8, 11 and 14 in the control arm. The median values of total, physical and mental fatigue are substantially lower on day 4 (19,13,5), day 8 (15, 10, 5), day 11 (10,7,4) and day 14 (8,5,3), respectively, when compared to day 0 (26,18,8) in the test arm as well as when compared to day 4 (23,16,8), day 8 (22,15,7), day 11 (20,14,7) and day 14 (19.5, 14, 7) in the control arm (Figure 3). The outliers in the upper range of the test arm represent subjects that were still experiencing fatigue at the end of the 14-day treatment period.…”

Section: Analysis Of Efficacymentioning

confidence: 93%

A Randomized Controlled Trial of the Efficacy of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue

Rathi¹,

Jadhav²,

Shah

2021

Medicines

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Muscle fatigue and cognitive disturbances persist in patients after recovery from acute COVID-19 disease. However, there are no specific treatments for post-COVID fatigue. Objective: To evaluate the efficacy and safety of the health supplements ImmunoSEB (systemic enzyme complex) and ProbioSEB CSC3 (probiotic complex) in patients suffering from COVID-19 induced fatigue. A randomized, multicentric, double blind, placebo-controlled trial was conducted in 200 patients with a complaint of post-COVID fatigue. The test arm (n = 100) received the oral supplements for 14 days and the control arm (n = 100) received a placebo. Treatment efficacy was compared using the Chalder Fatigue scale (CFQ-11), at various time points from days 1 to 14. The supplemental treatment resulted in resolution of fatigue in a greater percentage of subjects in the test vs. the control arm (91% vs. 15%) on day 14. Subjects in the test arm showed a significantly greater reduction in total as well as physical and mental fatigue scores at all time points vs. the control arm. The supplements were well tolerated with no adverse events reported. This study demonstrates that a 14 days supplementation of ImmunoSEB + ProbioSEB CSC3 resolves post-COVID-19 fatigue and can improve patients’ functional status and quality of life.

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Section: Analysis Of Efficacymentioning

confidence: 93%

A Randomized Controlled Trial of the Efficacy of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue

Rathi¹,

Jadhav²,

Shah

2021

Medicines

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“…The economic burden of ME/CFS is substantial, with unemployment rates in the range of 35–69%. The annual cost of ME/CFS is estimated at $18–$24 billion in the USA [ 131 , 132 ]. Currently, there is no definitive treatment for ME/CFS [ 52 , 57 ].…”

Section: What Can Be Done?mentioning

confidence: 99%

“…Currently, there is no definitive treatment for ME/CFS [ 52 , 57 ]. Therapeutic approaches to ME/CFS can be categorized into central nervous system drugs, antivirals, immunomodulators, analgesics, and nutritional supplements [ 132 ]. Antidepressants remain one of the most commonly prescribed classes of medication for ME/CFS [ 132 ].…”

Section: What Can Be Done?mentioning

confidence: 99%

“…Therapeutic approaches to ME/CFS can be categorized into central nervous system drugs, antivirals, immunomodulators, analgesics, and nutritional supplements [ 132 ]. Antidepressants remain one of the most commonly prescribed classes of medication for ME/CFS [ 132 ]. The monoamine oxidase inhibitor moclobemide in a randomized clinical trial (RCT) showed improvement in symptoms, but the difference was not statistically significant [ 133 ].…”

Section: What Can Be Done?mentioning

confidence: 99%

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The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 Infection

Moghimi

Napoli

Biller

et al. 2021

Curr Neurol Neurosci Rep

149

102

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Purpose of Review Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global health challenge. This review aims to summarize the incidence, risk factors, possible pathophysiology, and proposed management of neurological manifestations of post-acute sequelae of SARS-CoV-2 infection (PASC) or neuro-PASC based on the published literature. Recent Findings The National Institutes of Health has noted that PASC is a multi-organ disorder ranging from mild symptoms to an incapacitating state that can last for weeks or longer following recovery from initial infection with SARS-CoV-2. Various pathophysiological mechanisms have been proposed as the culprit for the development of PASC. These include, but are not limited to, direct or indirect invasion of the virus into the brain, immune dysregulation, hormonal disturbances, elevated cytokine levels due to immune reaction leading to chronic inflammation, direct tissue damage to other organs, and persistent low-grade infection. A multidisciplinary approach for the treatment of neuro-PASC will be required to diagnose and address these symptoms. Tailored rehabilitation and novel cognitive therapy protocols are as important as pharmacological treatments to treat neuro-PASC effectively. Summary With recognizing the growing numbers of COVID-19 patients suffering from neuro-PASC, there is an urgent need to identify affected individuals early to provide the most appropriate and efficient treatments. Awareness among the general population and health care professionals about PASC is rising, and more efforts are needed to understand and treat this new emerging challenge. In this review, we summarize the relevant scientific literature about neuro-PASC.

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“…Graham et al (Mar 2021) [36]Research Article A prospective study of the first 100 consecutive patients (50 SARS-CoV-2 laboratory-positive (SARS-CoV-2 + ) and 50 laboratory-negative (SARS-CoV-2 − ) individuals) presenting to the Neuro-Covid-19 clinic between May and November 2020 concluded that non-hospitalized COVID-19 "long-haulers" experience prominent and persistent "brain fog" and fatigue that affect their cognition and quality of life. Toogood et al (Mar 2021)[37] …”

mentioning

confidence: 99%

Shadow Burden of Undiagnosed Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) on Society: Retrospective and Prospective—In Light of COVID-19

Arāja

Berķis

Lunga

et al. 2021

JCM

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Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a poorly understood, complex, multisystem disorder, with severe fatigue not alleviated by rest, and other symptoms, which lead to substantial reductions in functional activity and quality of life. Due to the unclear aetiology, treatment of patients is complicated, but one of the initial problems is the insufficient diagnostic process. The increase in the number of undiagnosed ME/CFS patients became specifically relevant in the light of the COVID-19 pandemic. The aim of this research was to investigate the issues of undiagnosed potential ME/CFS patients, with a hypothetical forecast of the expansion of post-viral CFS as a consequence of COVID-19 and its burden on society. Methods: The theoretical research was founded on the estimation of classic factors presumably affecting the diagnostic scope of ME/CFS and their ascription to Latvian circumstances, as well as a literature review to assess the potential interaction between ME/CFS and COVID-19 as a new contributing agent. The empirical study design consisted of two parts: The first part was dedicated to a comparison of the self-reported data of ME/CFS patients with those of persons experiencing symptoms similar to ME/CFS, but without a diagnosis. This part envisaged the creation of an assumption of the ME/CFS shadow burden “status quo”, not addressing the impact of COVID-19. The second part aimed to investigate data from former COVID-19 patients’ surveys on the presence of ME/CFS symptoms, 6 months after being affected by COVID-19. Descriptive and analytical statistical methods were used to analyse the obtained data. Results: The received data assumed that the previously obtained data on the ME/CFS prevalence of 0.8% in the Latvian population are appropriate, and the literature review reports a prevalence of 0.2–1.0% in developed countries. Regarding the reciprocity of ME/CFS and COVID-19, the literature review showed a lack of research in this field. The empirical results show quite similar self-esteem among ME/CFS patients and undiagnosed patients with longstanding disease experience, while former COVID-19 patients show a significantly lower severity of these problems. Notably, “psychological distress (anxiety)” and “episodic fatigue” are significantly predominant symptoms reported by former COVID-19 patients in comparison with ME/CFS patients and undiagnosed patients prior to the COVID-19 pandemic. The results of our analysis predict that the total amount of direct medical costs for undiagnosed patients (out-of-pocket payments) is more than EUR 15 million p.a. (in Latvia), and this may increase by at least 15% due to the consequences of COVID-19. Conclusions: ME/CFS creates a significant shadow burden on society, even considering only the direct medical costs of undiagnosed patients—the number of whom in Latvia is probably at least five times higher than the number of discerned patients. Simultaneously, COVID-19 can induce long-lasting complications and chronic conditions, such as post-viral CFS, and increase this burden. The Latvian research data assume that ME/CFS patients are not a high-risk group for COVID-19; however, COVID-19 causes ME/CFS-relevant symptoms in patients. This increases the need for monitoring of patients for even longer after recovering from COVID-19′s symptoms, in order to prevent complications and the progression of chronic diseases. In the context of further epidemiological uncertainty, and the possibility of severe post-viral consequences, preventive measures are becoming significantly more important; an integrated diagnostic approach and appropriate treatment could reduce this burden in the future.

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Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): Where will the drugs come from?

Cited by 46 publications

References 122 publications

A Randomized Controlled Trial of the Efficacy of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue

A Randomized Controlled Trial of the Efficacy of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue

The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 Infection

Shadow Burden of Undiagnosed Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) on Society: Retrospective and Prospective—In Light of COVID-19

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