Research Roundup: ME/CFS Research Published 23-29 October 2021

November 4, 2021

The weekly research round-up includes recent publications about ME/CFS and Long Covid. We highlight the studies that have particularly caught our interest and follow these with the full list of publications together with their abstracts (summaries).

All research relating to ME/CFS can be located in the ME Association: Index of ME/CFS Published Research. It is a FREE resource, available to anyone, and updated at the beginning of each month.

The Index provides an A-Z of published research studies, selected key documents and articles, listed by subject matter, on myalgic encephalomyelitis, myalgic encephalopathy, and/or chronic fatigue syndrome (ME/CFS).

You can use it to easily locate and read any research that you might be interested in regard to, e.g., epidemiology, infection, neurology, post-exertional malaise etc.

You can also find the Research Index in the Research section of the website together with a list of Research Summaries that provide more detailed lay explanations of the more interesting work that has been published to date.

ME/CFS Research Published 23 – 29 October 2021  

Five new research studies on ME/CFS and fourteen studies on Long Covid have been published this week. Within the published ME/CFS research, I have included two of the reports on the new NICE guidelines.  

We have highlighted two papers on ME/CFS from the selection below: 

Paper one (1) gives a good overview on our current knowledge of ME/CFS. While dense to read, the authors review previously published papers on the role of inflammation, immunity, genetics, epigenetics, cognitive symptoms, dysbiosis, non-coding RNAs, and hormones in ME/CFS pathogenesis.  

The review does not provide any new conclusions, or express which research direction would be the most important to advance. The authors conclude that ME/CFS is a multi-factorial disease with huge heterogeneity and complexity making advances in biomarkers difficult. The authors express that the individual variability is remarkable and needs to be considered in developing therapeutic tools, and tailored approaches are needed. 

It is also timely with the publishing of the new NICE guidelines, as the authors talk about exercise therapy and the studies which show that symptoms improve. Therefore, some updating is needed. 

Paper two (2) looks into whether a biomarker for ME/CFS could be found in saliva. Finding a biomarker is critically important to ME/CFS as it will enable more timely accurate diagnosis. This would also help patients to manage their energy levels sooner and lead to developing new management techniques, targeting molecules identified in biomarkers. 

This study looks at two peptides (short chain of amino acids) in 59 patients with ME/CFS and 39 controls. The findings of this study are promising, with the authors finding significant differences between severe patients and healthy controls. 

Unfortunately, this paper is behind a paywall with the abstract not giving away much. However, it would be a huge step forward in research if severe ME/CFS could be distinguished from mild/moderate. With the information we have, it is unclear whether mild/moderate ME/CFS was looked at in this study, or if it was just severe verus controls, which would make the results less surprising.  

ME/CFS Research References and Abstracts  

1. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): An Overview 

Deumer US, Varesi A, Floris V, Savioli G, Mantovani E, López-Carrasco P, Rosati GM, Prasad S, Ricevuti G.
J Clin Med. 2021 Oct 19;10(20):4786.  


Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic systemic disease that manifests via various symptoms such as chronic fatigue, post-exertional malaise, and cognitive impairment described as “brain fog”. These symptoms often prevent patients from keeping up their pre-disease onset lifestyle, as extended periods of physical or mental activity become almost impossible.  

However, the disease presents heterogeneously with varying severity across patients. Therefore, consensus criteria have been designed to provide a diagnosis based on symptoms.  

To date, no biomarker-based tests or diagnoses are available, since the molecular changes observed also largely differ from patient to patient.  

In this review, we discuss the infectious, genetic, and hormonal components that may be involved in CFS pathogenesis, we scrutinize the role of gut microbiota in disease progression, we highlight the potential of non-coding RNA (ncRNA) for the development of diagnostic tools and briefly mention the possibility of SARS-CoV-2 infection causing CFS. 

2. Saliva fatigue biomarker index as a marker for severe myalgic encephalomyelitis/chronic fatigue syndrome in a community based sample 

Leonard A. Jason, John Kalns, Alicia Richarte, Ben Z. Katz & Chelsea Torres  
Fatigue: Biomedicine, Health & Behavior Abstract 

ObjectiveThe prevalence of pediatric Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has been estimated from an ethnically and sociodemographically diverse community-based random sample of 10,119 youth aged 5–17. We assessed whether a salivary biomarker of fatigue could identify youth with ME/CFS. 

Study designWe examined the ratio of the concentrations of 2 peptide fragments in saliva, referred to as the Fatigue Biomarker Index (FBI), in participants from our study diagnosed with ME/CFS (n = 59) and matched controls (n = 39). 

ResultsSignificant overall differences were found in the FBI between those participants with severe ME/CFS and those with ME/CFS and the controls. 

ConclusionsIf confirmed in other populations, the FBI could serve as an objective test to aid in the diagnosis of severe ME/CFS. 

3NICE understates role of exercise and CBT in managing ME/CFS, say medical leaders 

Kmietowicz Z.  
BMJ. 2021 Oct 29;375:n2647.  

No abstract available. 

4ME/CFS: Exercise goals should be set by patients and not driven by treatment plan, says NICE 

Torjesen I.  
BMJ. 2021 Oct 29;375:n2643.  

No abstract available. 

(N.B Dr Charles Shepherd has provided a comment on this article) 

5. Can prolong life with nine turn method (Yan Nian Jiu Zhuan) Qigong alleviates Fatigue, Sleep quality, Depression and anxiety on Patients with Chronic Fatigue Syndrome: a Randomized, Controlled, Clinical Study? 

Fangfang Xie, Jiatuo Xu, Chong Guan, Ziji Cheng, Yuanjia Gu, Ziying Chen, Chaoqun Xie, Jue Wang, Yuling Shi, XuXiang Ma, Tao Jiang, Fei Yao, Yanli You 
ResearchSquare. Preprint  Abstract 

BackgroundChronic fatigue syndrome (CFS) is a complex disease with unknown etiology and mechanism. Prolong life with nine turn method (PLWNT) Qigong is a system of mind-body exercise with restorative benefits that have shown a wide range of benefits in the treatment of CFS. The purpose of this study is to investigate the effect of PLWNT Qigong exercise on CFS with a focus on fatigue, sleep quality, depression and anxiety. 

MethodsA total of 135 participants were randomly divided into treatment groups and control group in the same proportion. The treatment groups received PLWNT Qigong exercise (PLWNT Group) or cognitive behavioral therapy treatment (CBT Group). The healthy control group (HC Group) does not receive any treatment and maintains daily life. Participants from treatment groups were taught by related highly qualified professor at the Shanghai University of Traditional Chinese Medicine once a week and were supervised online during the remaining 6 days at home, over 12 consecutive weeks. The primary outcome was fatigue (MFI-20) and secondary outcomes were sleep quality (PSQI), anxiety and depression (HADS). All groups were measured at baseline (T0) and post-intervention (T1). 

Results134 patient completed the study (45 in the PLWNT Group, 44 in the CBT Group and 45 in HC Group). The within group comparison of PLWNT and CBT groups were all showed significant improvement in MFI-20, PSQI and HADS after the intervention (p༜0.05). No significant difference was found between the PLWNT group and CBT group(p༞0.05),but the total effective rate of the PLWNT group was 62.22%, which was higher than the CBT group was 50.00%. The changes in the PLWNT group and CBT group were all higher than those in the HC group except for habitual sleep efficiency and sleep medicine using(p༜0.05). In additional, fatigue degree changes in the PLWBT group were positively correlated with sleep degree (r=0.315) and anxiety degree(r=0.333), but only anxiety degree(r=0.332) was found to be positively correlated with fatigue in the CBT group. 

ConclusionPLWNT Qigong exercise has the potential as a rehabilitation method on CFS with a focus on fatigue, sleep quality, anxiety and depression. Yet, the results need to be interpreted carefully and needs to be repeated in a larger sample. Future studies will expand the sample size for further in-depth research to determine the frequency and intensity of PLWNT Qigong intervention that is particularly beneficial to CFS. The study registered in the American Clinical Trial Registry on 4 November 2018, the registration number is NCT03496961. 

Long-COVID Research References   

  1. COVID-19 in children. II: Pathogenesis, disease spectrum and management 
  1. Reflections on the potential role of acupuncture and Chinese herbal medicine in the treatment of Covid-19 and subsequent health problems 
  1. Antibodies from previous infection bring sufficient and long-term protection against COVID-19 
  1. Exploring the scope of homoeopathy in combating the unfortunate consequences of post-COVID-19 survivors based on non-COVID conditions: a narrative review 
  1. Intensive care-treated COVID-19 patients' perception of their illness and remaining symptoms 
  1. Reactive oxygen species, proinflammatory and immunosuppressive mediators induced in COVID-19: overlapping biology with cancer 
  1. Post-COVID-19 complications: Multisystemic approach 
  1. Long COVID: rheumatologic/musculoskeletal symptoms in hospitalized COVID-19 survivors at 3 and 6 months 
  1. Supporting patients with long COVID return to work 
  1. Long COVID: playing the long game 
  1. A Short Corticosteroid Course Reduces Symptoms and Immunological Alterations Underlying Long-COVID 
  1. Long-term consequences of COVID-19 on cognitive functioning up to 6 months after discharge: role of depression and impact on quality of life 
  1. Long-covid: cognitive deficits (brain fog) and brain lesions in non-hospitalized patients 
  1. Predictors of Long Covid 19 Syndrome 

Dr Katrina Pears,
Research Correspondent.
The ME Association.

Dr Katrina Pears - MEA Research Correspondent



Shopping Basket