ME/CFS and Long Covid Research: 04 – 10 January 2022

January 14, 2022

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).

Listen to the Research Roundup on our Podcast

Katrina Pears covers the research from this roundup and comments on how useful they are for the ME/CFS community.


The ME Association maintains a comprehensive index of published research on ME/CFS and Long Covid that is free to use and updated weekly.

ME/CFS Research Published 4 – 10 January 2022 

It has been an exceptionally quiet week for ME/CFS research, there have been two new research studies but fourteen studies on Long Covid this week.  

Neither of the studies published this week add to our understanding of disease pathology. We have briefly discussed the content of these two studies below:  

Paper one (1) follows on from one of the studies we reported last week, the use of Oxygen-Ozone Autohemotherapy (O2-O3-AHT) as a potential treatment option. This paper differs as it looks at the difference between male verus female treatment response, finding much more positive results in females. 

However, this paper is almost an exact copy of the study reported last week. It feels that the authors are trying to boost their research paper count, this result is mentioned in the previous research and doesn’t warrant its own paper. There is actually only one graph presented in this study. 

Due to the nature of the research paper being a brief report, there are a lot of details missing about the trial, such as: 

  • What were the exact number of treatments received? The study says “no fewer than two weekly sessions”, this could mean some had 7 treatments, while others had two. 
  • What is the degree patient functioning such as mild, moderate or severe ME/CFS? 
  • Would the patients in this trial have been attending and paying for treatment anyway? 

I personally feel this study could yield some interesting data with a more in-depth study. I have personally tried intravenous ozone therapy, receiving 20 treatments in 30 days. While I didn’t see any improvement in my fatigue or other symptoms, others attending the clinic did report improvements in a range of symptoms. (NB- the ME Association does not endorse any treatment options). 

Paper two (2) while not directly related to ME/CFS, is relevant to many studies performed where degrees of fatigue are assessed. This study looked at comparing two commonly used fatigue scoring questionnaires: Korean version of the Multidimensional Fatigue Inventory (MFI-K) and the modified Chalder Fatigue Scale (mKCFQ).  

The study showed that these two questionnaires are useful tools for measuring fatigue and it is unsurprising that the two methods gave similar results! However, interestingly the authors noted that “MFI-K may be useful for conditions of moderate-to-severe fatigue, such as chronic fatigue syndrome”. Although the validity of this study can be questioned, as the authors modified the scales for use in the study “To resolve the difficulty of assessment based on the comparison with the “usual” status, the mKCFQ was adapted”. 

ME/CFS Research References and Abstracts  

1. Male vs. Female Differences in Responding to Oxygen–Ozone Autohemotherapy (O2-O3-AHT) in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) 

Chirumbolo, S.; Valdenassi, L.; Franzini, M.; Pandolfi, S.; Ricevuti, G.; Tirelli, U.  
J. Clin. Med.2022, 11, 173.  


(1) Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a syndrome that has fatigue as its major symptom. Evidence suggests that ozone is able to relieve ME/CFS-related fatigue in affected patients.  

(2) Objective: To evaluate whether differences exist between males and females in ozone therapy outputs in ME/CFS.  

(3) Methods: In total, 200 patients previously diagnosed with ME/CFS (mean age 33 ± 13 SD years) underwent treatment with oxygen–ozone autohemotherapy (O2-O3-AHT). Fatigue was investigated via an FSS 7-scoring questionnaire before and following 1 month after treatment.  

(4) Results: The Mann-Whitney test (MW test) assessed the significance of this difference (H = 13.8041, p = 0.0002), and female patients showed better outcomes than males. This difference was particularly striking in the youngest age cohort (14–29 years), and a KW test resulted in H = 7.1609, p = 0.007 for the Δ = 28.3% (males = 3.8, females = 5.3).  

(5) Conclusions: When treated with O2-O3-AHT, females respond better than males. 

2. Comparison of assessment scores for fatigue between multidimensional fatigue inventory (MFI-K) and modified chalder fatigue scale (mKCFQ) 

Lim EJ, Son CG. 
J Transl Med. 2022 Jan 3;20(1):8. doi: 10.1186/s12967-021-03219-0. 


Background: Because of the absence of biological parameters for fatigue, appropriate instruments for assessing the degree of fatigue are important in the diagnosis and management of people complaining of fatigue-like symptoms. This study statistically analyzed the fatigue scores from two typical questionnaire-based instruments: the Korean version of the Multidimensional Fatigue Inventory (MFI-K) and the modified Chalder Fatigue Scale (mKCFQ). 

Methods: Seventy participants (males n = 40, females n = 30, median age 48 years old, range of 25-67) were grouped into three groups (‘mild' = 20, ‘moderate' = 42, and ‘severe' = 8) according to self-reported fatigue levels using a 7-point Likert scale. The similarities and differences between two instrument-derived scores were analyzed using correlations (r) and multidimensional scaling (MDS). 

Results: The total scores of the two assessments were significantly correlated (r = 75%, p < 0.001), as were the subscores (‘Total Physical fatigue': r = 76%, p < 0.001, ‘Total Mental fatigue': r = 56%, p < 0.001). Relative overestimation of the MFI-K (45.8 ± 11.3) compared to the mKCFQ (36.1 ± 16.2) was observed, which was especially prominent in the ‘mild' group. The scores of the three groups were more easily distinguished by the mKCFQ than by the MFI-K. In terms of the five dimension scores, we found a higher correlation of the two assessments for ‘general fatigue' (r = 79%, p < 0.001) and ‘physical fatigue' (r = 66%, p < 0.001) than for the reductions in ‘motivation' (r = 41%, p < 0.01) and ‘activity' (r = 26%, p > 0.05). 

Conclusions:  Our results may indicate the usefulness of the two instruments, especially for the physical symptoms of fatigue (‘general' and ‘physical' fatigue). Furthermore, the MFI-K may be useful for conditions of moderate-to-severe fatigue, such as chronic fatigue syndrome, but the mKCFQ may be useful for all spectra of fatigue, including in subhealthy people.

Long-COVID Research References   

  1. Physiological predictors of long-term effects of covid-19 in patients with sars-cov-2: focus on lymphocyte proliferation-improving micronutrients 
  1. A Mobile Health Application for the Fibromyalgia-Like Post-COVID19 Syndrome: Study Protocol for User Experience and Clinical Data Analysis 
  1. Skeletal muscle alterations in patients with acute Covid-19 and post-acute sequelae of Covid-19 
  1. Global surveillance, research, and collaboration needed to improve understanding and management of long COVID 
  1. The Long-COVID Syndrome: smoking and enhanced suicide risk 
  1. PD-1 blockade counteracts post-COVID-19 immune abnormalities and stimulates the anti-SARS-CoV-2 immune response 
  1. Cerebrospinal Fluid Analysis Post-COVID-19 Is Not Suggestive of Persistent Central Nervous System Infection 
  1. Long COVID symptoms and duration in SARS-CoV-2 positive children – a nationwide cohort study 
  1. Role of Nutritents for COVID-19 recovery: an integrative approach 
  1. Successful application of pulsed electromagnetic fields in a patient with post-COVID-19 fatigue: a case report 
  1. Evaluation of 3-month follow-up of patients with post-acute COVID-19 syndrome 
  1. Premorbid vulnerability and disease severity impact on Long-COVID cognitive impairment 
  1. Symptoms Experienced at the Acute Phase of SARS-CoV-2 Infection as Risk Factor of Long-term Post-COVID Symptoms: The LONG-COVID-EXP-CM Multicenter Study 
  1. Prevalence, characteristics, and predictors of Long COVID among diagnosed cases of COVID-19 


Dr Katrina Pears,
Research Correspondent.
The ME Association.

Dr Katrina Pears - MEA Research Correspondent



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