BMJ overlap COVID and ME/CFS

British Medical Journal returns to the overlaps between Long Covid and ME/CFS

The BMJ has an article on how Long COVID is helping the understanding of postviral syndromes. The full article can be read from the link below


The list of infectious diseases linked to long term symptoms includes Ebola, West Nile virus, polio, and Lyme disease. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is also thought to be a postviral syndrome.

While these diseases all have different acute symptoms, the symptoms associated with their post-infection syndromes tend to be remarkably similar: fatigue, neurological impairments, muscle and joint pain, sleep disturbances, and irritability are all common, says Andrew Lloyd, an infectious disease physician at the University of New South Wales in Sydney, Australia – although each acute infection tends to add its own “flavour” or specific symptom.

Finding a common cause of the various syndromes would be a breakthrough in postviral syndrome research.

Several hypotheses have been put forward, including persistent but undetected infections, autoimmune responses, dysregulation of the microbiome, and tissue damage. But Andrew Lloyd of the University of New South Wales mostly dismisses those ideas. “The lessons we’ve learned from other post-infection syndromes is that it is not a persistent infection, not immunological, not a simple psychological disorder,” he says.

Among researchers who study these illnesses, including long covid, the smart money is now on some kind of disorder of the central nervous system, he explains. And since there’s no clear evidence of any major structural problems in the brain, this suggests that the disorder lies at the cellular and protein level.

“There is some circumstantial evidence to support that,” he says. “But nothing concrete yet.”

MEA Comment

The ME Association has been providing information and support to people with Long Covid dating back to May 2020 – when it became apparent that significant numbers of people were not recovering from COVID-19 and developing a post-covid syndrome that included symptoms that are the same as ME/CFS.

Since then we have continued to cover all aspects of Long Covid on our social media and regularly report on research and treatment developments.

We are very happy for people with Long Covid to join the ME patient community and take part in our discussions on MEA Facebook.

We have, however, been critical of the way in which huge amounts of money and research capacity has been directed at the cause and treatment of Long Covid when people with ME/CFS have faced a serious lack of government funded biomedical research into the cause and treatment of ME/CFS for many years.

We have also been critical of the way in which many clinicians and researchers have failed to acknowledge the important clinical and causative overlaps between Long Covid and ME/CFS and the failure to realise that what we know about the cause and management of of ME/CFS – especially activity and energy management – could help people with Long Covid.


This is our new guide to the clinical and pathological overlaps between ME/CFS and Long Covid

This guide also explains how we can help people with Long Covid who have ME/CFS like symptoms – debilitating fatigue and post exertional malaise, cognitive dysfunction, unrefreshing sleep, orthostatic intolerance, PoTS etc

Free website download

Dr Charles Shepherd,
Trustee and
Hon. Medical Adviser
to the ME Association.
Member of the 2018-2021 NICE Guideline Committee.
Member of the 2002 Independent Working Group on ME/CFS.

Dr Charles Shepherd
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