Pharma Tech : Could chronic fatigue syndrome be taken seriously at last?

An article has appeared on the Pharma Technology Focus website examining whether CFS will be taken more seriously with the growing incidence of long COVID and features quotes from Dr Shepherd

Visit the Pharma site for the full article from the button below and some extracts featuring Dr Charles Shepherd are shown in this post.

‘Long Covid’ has become shorthand for a wide range of post-viral symptoms experienced by some patients following a Covid-19 infection. Cases of chronic fatigue after acute respiratory illness are far from unprecedented, but the scale at which they are now occurring is unprecedented. Advocates for patients with similar illnesses are now hoping that the attention being given to long Covid could help improve care for these illnesses as well. Chloe Kent reports.

Intro from Article

“Any viral infection can cause a short-lived period of fatigue,” says ME Association medical adviser Dr Charles Shepherd. “That’s extremely common. What’s less common, but still reasonably so, is people who get a viral infection followed by post-viral fatigue syndrome, where you’ve got other symptoms like brain fog, feeling fluey, glands up, that sort of thing. That follows a lot of viral infections and goes on for a few weeks, and then people get over it and get better again.

“Then there’s the third group, where post-viral fatigue doesn’t resolve for three months or more and has a significant effect on what you can do – you can’t get back to work or normal life. At that point, most people would get a diagnosis of ME. That’s paralleling what’s happening for quite a few people with long Covid. There clearly is a lot of overlap between the two.”

Shepherd says: “There’s still an awful lot of doctors out there who either don’t believe in ME or believe it’s all in the mind and are pretty dismissive and in some cases quite nasty to patients.”

Shepherd says: “Because ME is a multi-system disease and there are these various different pathological tracks going on within it, there are different therapeutic interventions going on in relation to the different components of it.”

“There’s quite a lot of emerging evidence of a range of dysfunction across the whole immune system orchestra, but in particular the role of cytokines. This may link in with some of the neuroimaging findings on what we call neuroinflammation,” says Shepherd. “This has led to various small studies as to whether drugs which can dampen down this type of immune system activation could be of help in people with ME and long Covid.”

“Mitochondria are sort of the Duracell batteries within muscle cells that are where energy is produced,” says Shepherd. 

“We’ve now got quite a lot of evidence showing that there’s a defect in metabolic energy production at a cellular level in people with ME, so there is a biochemical explanation for the fatigue that is going on.

“Whether there’s mitochondrial dysfunction going on in long Covid I don’t know, because no one’s really had the time of the opportunity to study it, but it’s certainly another possibility for therapeutic intervention.”

Shepherd says: “Although there’s all this great overlap between ME/CFS and long Covid there’s been a great reluctance in the long Covid patient community especially, especially among doctors involved in its treatment, to actually accept this overlap. They don’t want long Covid people to just get landed with all the problems people with ME have had with recognition.

A step in the right direction is a step in the right direction, even when some patients may feel it’s too little too late.

“There’s this sort of tension between the two communities, a lot of quite understandable anger if you look on social media. People are constantly saying ‘look, we’ve been living with an illness like long Covid for 30 years and no one’s taken us seriously’, and now there’s all this money ploughed into research and all these clinics set up overnight.”

Shepherd says: “As time goes on there’s going to be much more acceptance about this overlap between the two conditions. It may well be that some of these long Covid clinics, once they’ve got a component that deals with Covid-type symptoms, are more help by becoming an ME/CFS service than they are a service primarily dealing with people who have long term respiratory and cardiac problems.”

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