Dr. Anthony Komaroff, CII Coordinator, 12 May 2020.
| THE CENTER FOR SOLUTIONS FOR ME/CFS The research center at Columbia University, committed to understanding the pathogenesis of ME/CFS. Led by Dr. W. Ian Lipkin of the Center for Infection and Immunity. |
Blog Extracts:
Why do some people get ME/CFS and others do not?
Will some people who get COVID-19 subsequently develop ME/CFS? After all, many people with ME/CFS say that their illness began with some kind of infection: “a virus,” “a flu,” “a bad cold.”
When it started, their illness didn’t feel that different from similar illnesses in the past, so no tests were done to determine what kind of infection it was.
Their doctors thought there was no need, since these minor infections typically get better. Only this one didn’t get better, and the cause of the initial illness remained a mystery.
Other times, there is no mystery; the initial infection is clearly diagnosed. It might be infectious mononucleosis (“mono”), or it might be Lyme disease.
The mystery then becomes why, after the clearly diagnosed illness has been treated, does the person remain sick for months and years thereafter?
There is abundant evidence that ME/CFS can follow apparently infectious illnesses of uncertain cause, or a clearly diagnosed infectious illness – including illnesses causes by viruses, bacteria, and even certain parasites.
What percentage of people might develop ME/CFS?
Perhaps the best study of whether ME/CFS can develop following an infectious illness is a study supported by the CDC but conducted in a small, isolated, rural town in Australia, a town where people rarely leave to travel elsewhere.
The town had one hospital, one laboratory, and a small group of doctors, making it easy to identify virtually every case of an infection that might lead to ME/CFS – and to follow people to see if they did develop ME/CFS.
In this study, 253 individuals who developed an infection with either Epstein-Barr virus (a DNA virus), Coxiella burnetti (intracellular bacterium), or Ross River virus (an RNA virus) were followed for the next year.
| The study found that ME/CFS developed in 11% of the people. The strongest predictor of a “post-infective fatigue syndrome” was the severity of the initial illness, as judged both by symptoms and by laboratory test abnormalities. |
In other words, objective and measurable biological abnormalities predicted who would develop ME/CFS. In contrast, people with a past history of psychiatric illness were not more likely to develop ME/CFS.
It is therefore entirely plausible that some cases of ME/CFS will develop in people who get COVID-19.
It is important to conduct studies that follow people with COVID-19 for several years, even after they recover, to see whether ME/CFS or other long-term complications will develop.
| Anthony Komaroff, MD Editor in Chief, Harvard Health Letter  Anthony Komaroff is the Steven P. Simcox/Patrick A. Clifford/James H. Higby Professor of Medicine at Harvard Medical School, senior physician at Brigham and Women’s Hospital in Boston, and editor in chief of the Harvard Health Letter. He was director of the Division of General Medicine and Primary Care at Brigham and Women’s Hospital for 15 years, and is the founding editor of Journal Watch, a summary medical information newsletter for physicians published by the Massachusetts Medical Society/New England Journal of Medicine. |
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