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).
RESEARCH INDEX
The ME Association maintains a comprehensive index of published research on ME/CFS and Long Covid that is free to use and updated weekly.
Audio commentary by Dr Katrina Pears
It’s been a busy week for research, with a large variety of different topics. There have been twelve new ME/CFS studies and twenty-six new Long Covid studies this week.
We have highlighted one of the ME/CFS studies in more detail below:
Paper two (2) is a systematic review and meta-analysis which looks into whether viral infections are the cause (etiology) of ME/CFS.
The study searched previously published research on viral infections in ME/CFS, finding 64 studies which met the inclusion criteria, with 18 different viruses (12 DNA virus, 4 RNA virus, 2 Retrovirus). This resulted in patient data from 4971 patients with ME/CFS being included with 9221 controls. The controls included heathy controls and “diseased controls” with one of ten diseases, such as multiple sclerosis (MS) and fibromyalgia (FM).
The study calculated the “odds ratio” (OR) of different types of virus infection on ME/CFS, this is a measure of association between exposure and an outcome. The OR represents the odds that an outcome (i.e. ME/CFS) will occur given a particular exposure (i.e. a viral infection), compared to the odds of the outcome occurring in the absence of that exposure. The researchers set the criteria for an odds ratio greater than 2 to be classed as a potentially risky virus infection.
This was a fairly small study, giving fairly limited findings. The researchers found borna disease virus (BDV) to be the viral infection most associated with developing ME/CFS. Other findings of the study were:
- Human herpes virus (HHV)-7 and parvovirus B19, alongside their co-infection (both types of DNA viruses) had odds greater than 2.0 on ME/CFS compared with controls. Meaning these are potentially risky viral infections.
- Borna disease virus (BDV), enterovirus and coxsackie B virus (all types of RNA viruses) had odds greater than 2.0 on ME/CFS compared with controls.
- BDV exceeded the cutoff with an odds ratio of ≥ 3.47 on ME/CFS compared to both healthy and diseased controls.
A few things to note about this study:
- The study also did not examine the patient characteristics in the previous research, therefore, we do not know the diagnostic criteria for those with ME/CFS and how well the cohorts were defined.
- Further to this, ten other diseases were included in the “disease controls”, which included MS and FM, but also chronic fatigue was listed. However, we do not know how the previous research distinguished between chronic fatigue and ME/CFS, which weakens the separation between the cohorts.
- The use of odds ratio is commented on to be difficult to interpret in other studies (epidemiological studies) by the authors, therefore, questions why the authors used this analysis tool. (Additionally it makes it difficult for the reader to interpret the results).
- The study only included research that was conducted in English, so limited what could be included.
- The study only included viral infections so we do not know the importance of bacterial or fungal infections on developing ME/CFS, however, viral infections are often thought to be significant to ME/CFS.
- There has been increasing evidence of the viral infection of Covid-19 in developing ME/CFS, therefore, it is a shame that this was not included, but at this point there was not enough data available for the researchers.
This study pulls together some interesting data from a wide range of viruses and demonstrates the possible cause of viruses in ME/CFS development. However, I feel that the results presented in this research are limited with still much more that needs to be understood about the role of viruses.
You may also be interested in reading this week:
- Paper three (3) which is on post-actuate Covid-19 vaccination syndrome (PACVS) in which chronic fatigue and dysautonomia can develop, this research can detect this change in diagnostic blood markers. However, it should be noted we do not know the prevalence and therefore risk of PACVS development.
- Paper six (6) which is on the plasma proteome signature in ME/CFS, with potential candidates being identified as possible biomarkers which included proteins involved in inflammation, cellular energy metabolism and vitamin B12 transport.
- Paper seven (7) which is on treating exercise capacity with pyridostigmine, and is found to improve aerobic capacity in ME/CFS. Pyridostigmine has already been found to help those with POTS, you can read Dr Charles Shepherd’s comments about this on Facebook.
- Paper eleven (11) which is on treatment with repetitive transcranial magnetic stimulation, and was found to alleviate a variety of symptoms.
ME/CFS Research References
Ioulia Barakou, Katie L. Hackett, Tracy Finch & Florentina Johanna Hettinga.
Annals of Medicine, 55:2.
Abstract
Purpose: To propose a comprehensive multidimensional model of activity pacing that improves health-related quality of life and promotes sustained physical activity engagement among adults with chronic conditions.
Materials and methods: A narrative review was conducted to examine the existing literature on activity pacing, health-related quality of life, pain and fatigue management, and physical activity promotion in chronic conditions.
Results: The literature revealed a lack of a cohesive approach towards a multidimensional model for using activity pacing to improve health-related quality of life. A comprehensive multidimensional model of activity pacing was proposed, emphasizing the importance of considering all aspects of pacing for sustained physical activity engagement and improved health-related quality of life.
The model incorporates elements such as rest breaks, self-regulatory skills, environmental factors, and effective coping strategies for depression/anxiety. It takes into account physical, psychological, and environmental factors, all of which contribute significantly to the enhancement of health-related quality of life, physical function, and overall well-being, reflecting a holistic approach.
Conclusions: The model offers guidance to researchers and clinicians in effectively educating patients on activity pacing acquisition and in developing effective interventions to enhance physical activity engagement and health outcomes among adults with chronic conditions. Additionally, it serves as a tool towards facilitating discussions on sustained physical activity and a healthy lifestyle for patients, which can eventually lead to improved quality of life.
2. Evaluation of viral infection as an etiology of ME/CFS: a systematic review and meta-analysis
Hwang JH, Lee JS, Oh HM, Lee EJ, Lim EJ, Son CG.
J Transl Med. 2023 Oct 28;21(1):763.
Abstract
Background: Myalgic encephalitis/chronic fatigue syndrome (ME/CFS) is a long-term disabling illness without a medically explained cause. Recently during COVID-19 pandemic, many studies have confirmed the symptoms similar to ME/CFS in the recovered individuals. To investigate the virus-related etiopathogenesis of ME/CFS, we conducted a systematic assessment of viral infection frequency in ME/CFS patients.
Methods: We conducted a comprehensive search of PubMed and the Cochrane Library from their inception through December 31, 2022, using selection criteria of viral infection prevalence in ME/CFS patients and controls. Subsequently, we performed a meta-analysis to assess the extent of viral infections' contribution to ME/CFS by comparing the odds ratio between ME/CFS patients and controls (healthy and/or diseased).
Results: Finally, 64 studies met our eligibility criteria regarding 18 species of viruses, including a total of 4971 ME/CFS patients and 9221 control subjects. The participants included healthy subjects and individuals with one of 10 diseases, such as multiple sclerosis or fibromyalgia. Two DNA viruses (human herpes virus (HHV)-7 and parvovirus B19, including their co-infection) and 3 RNA viruses (borna disease virus (BDV), enterovirus and coxsackie B virus) showed odds ratios greater than 2.0 compared with healthy and/or diseased subjects. Specifically, BDV exceeded the cutoff with an odds ratio of ≥ 3.47 (indicating a “moderate association” by Cohen's d test) compared to both healthy and diseased controls.
Conclusion: This study comprehensively evaluated the risk of viral infections associated with ME/CFS, and identified BDV. These results provide valuable reference data for future studies investigating the role of viruses in the causation of ME/CFS.
Semmler A, Mundorf AK, Kuechler AS, Schulze-Bosse K, Heidecke H, Schulze-Forster K, Schott M, Uhrberg M, Weinhold S, Lackner KJ, et al.
Vaccines. 2023; 11(11):1642.
Abstract
SARS-CoV-2 mRNA vaccination can entail chronic fatigue/dysautonomia tentatively termed post-acute COVID-19 vaccination syndrome (PACVS). We explored receptor autoantibodies and interleukin-6 (IL-6) as somatic correlates of PACVS.
Blood markers determined before and six months after first-time SARS-CoV-2 vaccination of healthy controls (N = 89; 71 females; mean/median age: 39/49 years) were compared with corresponding values of PACVS-affected persons (N = 191; 159 females; mean/median age: 40/39 years) exhibiting chronic fatigue/dysautonomia (≥three symptoms for ≥five months after the last SARS-CoV-2 mRNA vaccination) not due to SARS-CoV-2 infection and/or confounding diseases/medications.
Normal vaccination response encompassed decreases in 11 receptor antibodies (by 25–50%, p < 0.0001), increases in two receptor antibodies (by 15–25%, p < 0.0001) and normal IL-6.
In PACVS, serological vaccination–response appeared significantly (p < 0.0001) altered, allowing discrimination from normal post-vaccination state (sensitivity = 90%, p < 0.0001) by increased Angiotensin II type 1 receptor antibodies (cut-off ≤ 10.7 U/mL, ROC-AUC = 0.824 ± 0.027), decreased alpha-2B adrenergic receptor antibodies (cut-off ≥ 25.2 U/mL, ROC-AUC = 0.828 ± 0.025) and increased IL-6 (cut-off ≤ 2.3 pg/mL, ROC-AUC = 0.850 ± 0.022).
PACVS is thus indicated as a somatic syndrome delineated/detectable by diagnostic blood markers.
4. Immune variation in infectious disease and during development early in life
Lucie Solène Tiaré Rodriguez.
PhD Thesis [Karolinska Institutet, Stockholm, Sweden]
Extract from Abstract
The human immune system is not only a complex system but a highly dynamic and heterogenous one. It consists of many specialized cells that stimulate and inhibit each other via proteins and physical interactions. And collectively these give rise to all kinds of immune responses necessary for our survival, but also causing diseases when not regulated properly or targeting healthy tissues1. Therefore systems-level analyses that simultaneously take all cell types and many proteins into account, allows us to understand immune dysregulation at the global level.
It is our goal to apply such methods to understand patients with poorly defined conditions, that likely have an inflammatory component yet are of unknown etiology and unknown pathogenesis. Integrating multiple layers of information offers a more detailed examination of cellular diversity and enhances the ability to pinpoint distinct cell types and their functions. To understand it one needs to be to be able to observe many interacting components and how they work to produce certain products. As accounting for hundreds cluster of differentiation (CD) antigens, as well as over 100 cytokines and chemokines with many cell subsets and tens of thousands of genes is daunting, it has been made more feasible by the advances in technology that have been made2.
In the first chapter, we navigate the intricate landscape of immune variation in diseases, with a specific focus on COVID-19 and post-infectious conditions such as ME/CFS and long COVID. Myalgic Encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) stands out as a complex, poorly understood multisystem ailment characterized by severe fatigue, flu-like symptoms, and an array of neurological and cognitive challenges.
Recent advancements in diagnostic criteria and proposed mechanisms have uncovered possible links between energy metabolism impairment, cognitive issues, autonomic dysfunction, and immune dysfunction.
ME/CFS is a heterogeneous condition affecting individuals of all ages, with a notable predilection for women. While diagnosis and treatment remain elusive, neuroimaging techniques show promise in identifying biomarkers for the disease. This section also delves into potential mechanisms underlying ME/CFS, including energy metabolism impairment, cognitive issues, autonomic dysfunction, and immune dysfunction. It explores the role of gut dysbiosis in ME/CFS, potential links between gastrointestinal issues and immune system disruptions, and how exaggeration of normal sickness behavior may contribute to symptoms. Moreover, the chapter draws parallels between ME/CFS and Nodding Syndrome in East Africa, shedding light on multifaceted disease models.
Despite the lack of curative treatments, advancements in neuroimaging techniques provide hope for the identification of ME/CFS biomarkers, potentially paving the way for improved diagnostic and therapeutic strategies. The study presented delves into ME/CFS, highlighting its intricate nature, possibly stemming from immune-microbe interactions within the gut.
Chronic immune activation, reflected in elevated cytokine levels and distinct cellular metabolism deficiencies, sets ME/CFS apart from other inflammatory disorders. The study underscores the condition's heterogeneity and proposes the failure to activate disease tolerance mechanisms during infections as a common denominator. These mechanisms are vital for limiting tissue damage due to infections and immune responses.
Notably, the study introduces INMEST treatment, which shows promise in upregulating disease tolerance pathways and offering potential symptom relief. Variations in symptom severity may be linked to changes in the infectious disease's nature or immune activation, with some severe ME/CFS cases exhibiting mutations in the IDO2 enzyme. INMEST treatment, while promising, necessitates larger trials, and the study suggests the development of self-treatment systems for home use to alleviate the burden of clinical visits.
Melby L, Nair RD.
Health Expect. 2023 Oct 31.
Abstract
Introduction: People should have access to healthcare services that are effective, safe and secure, patient-centred, and coordinated and continuous. One group that has consistently reported negative experiences and feels dissatisfied with services are patients with Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS). The objective of this study was to develop a deeper understanding of the experiences of dissatisfaction among ME/CFS patients and explore the reasons for such dissatisfaction.
Methods: We conducted in-depth interviews with 48 people from 24 households (comprising patients and family members), providing insight into the experiences of 37 ME/CFS sufferers in Norway. The participants were purposively sampled and included persons of different ages, genders, time since having the condition (3-30 years), and severity.
Results: Four main themes were developed: (1) ‘Nonexistent services' cover patients' experience that healthcare services had nothing to offer them after receiving their ME/CFS-diagnosis. (2) ‘Nonpersonalised services' documents experiences where patients did receive services, which in theory was appropriate for relieving a specific health problem, but in practice were experienced as inappropriate because they were not adapted to the patient's need. (3) ‘Slow services' address patients' experience of getting services too late (or too little) to be useful. (4) ‘Wrong services' comprise patients' experiences of being offered and/or ‘forced' to accept services that they felt were inappropriate for their health problems.
Conclusions: Providers' lacking knowledge of the condition and lack of precise recommendations for follow up may partly explain unsatisfactory experiences. Providers' belief (or disbelief) in the condition could furthermore influence caregiving. Also, systemic issues in the healthcare sector, like high workloads and bureaucracy, can negatively affect care provision. Finally, users' unsatisfactory experiences may also be due to a lack of patient involvement in the design of such services. Further research should investigate how patients can be involved in service design, and also providers' perspectives on caregiving and the barriers they experience for providing high-quality care.
Johanna Squires, Sarra Al-Zayer, Peng Li, Wenzhong Xiao, David Systrom.
European Respiratory Journal 2023 62: PA2960.
Abstract
Background: ME/CFS is a complex disease with unclear etiology. Current diagnostic criteria lack objective laboratory measures.
Aims: This study aimed to investigate the plasma proteomic profile of ME/CFS patients and determine any differentially expressed proteins compared to controls.
Methods: Plasma samples obtained from 19 ME/CFS patients and 9 controls underwent analysis (Somalogic, Inc, CO). The ME/CFS patients met the National Academy of Medicine criteria for the disease. Samples were collected from a mixed venous compartment. Statistical analysis and a Mixed Graphical Model were used to identify candidate biomarker.
Results: Among ~7000 proteins detected, ~400 were differentially expressed between patients and controls (False Discovery Rate<0.05 and Absolute Fold Change ≥1.5). Selectin E (SELE), ATP Synthase Subunit F6 (ATP5PF), and Transcobalamin 2 (TCN2) were identified as top candidates. A classifier of these proteins in pulmonary artery blood of patients were distinguishable from controls (AUC =0.99).
Conclusion: The study highlighted potential biomarkers for ME/CFS, the top candidates of which are involved in inflammation, cellular energy metabolism, and Vitamin B12 transport. The plasma proteomic signature identifies ME/CFS from normals and suggests that the disease’s pathophysiology is driven by abnormalities of aerobic metabolism, vascular dysregulation, and Vitamin B12 metabolism.
Johanna Squires, Sarra Al-Zayer, David Systrom.
European Respiratory Journal 2023 62: PA4639.
Abstract
Background: The pathophysiology underlying exertional intolerance in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) remains poorly understood. Previously, a single-dose of 60 mg pyridostigmine, a reversible acetylcholinesterase inhibitor, was found to acutely improve aerobic capacity (Joseph, P. et al. Chest 2022; 162:1116–26).
Aims: To build upon these prior findings, this study aimed to evaluate the long-term effect (>1 month) of pyridostigmine treatment on exercise intolerance in ME/CFS.
Methods: Between 2017-2022, patients who met the National Academy of Medicine criteria for ME/CFS, and had a minimum of two clinical, constant load, submaximal exercise tests (Shape Medical System, MN) were evaluated. Patients who began pyridostigmine after their baseline test were considered the treatment group. Measurements were taken at baseline (T0) and most recent follow-up (T1).
Results: At the follow-up evaluation (690 ± 547 days), the treatment group (n=37, dose range: 24-360mg/d) demonstrated a significant increase in oxygen uptake efficiency slope (OUES) (T0: 1.82 ± 0.56, T1: 1.98 ± 0.53; p=0.044) and pulmonary vascular capacitance (PVCAP) (T0: 486.19 ± 169.89 ml*mmHg, T1: 540.03 ± 170.59 ml*mmHg; p=0.040). These differences were not observed in the control group (n=16) OUES (T0: 1.62 ± 0.40, T1: 1.77 ± 0.47; p=0.268) and PVCAP (T0: 446.94 ± 144.80 ml*mmHg, T1: 465.81 ± 124.34 ml*mmHg; p=0.590).
Conclusion: Long-term treatment with pyridostigmine improved aerobic capacity in ME/CFS as demonstrated by an increase in OUES, mediated by improvements in central hemodynamics (PVCAP).
Hirano, Shin-ichi; Ichikawa, Yusuke; Sato, Bunpei; Takefuji, Yoshiyasu; Satoh, Fumitake.
Medical Gas Research 14(2):p 84-86, June 2024.
Abstract
No abstract available.
9. Are Sexual Assaults Related to Functional Somatic Disorders? A Cross-Sectional Study
Jacobsen SA, Frostholm L, Buhmann CB, Petersen MW, Ørnbøl E, Dantoft TM, Bjerregaard AA, Eplov LF, Carstensen TBW.
International Journal of Environmental Research and Public Health. 2023; 20(20):6947.
Abstract
An increasing number of sexual assaults (SAs) are being reported. This study investigated associations between SA and FSD, conceptualized as bodily distress syndrome (BDS), and five functional somatic syndromes (FSSs): chronic widespread pain (CWP), irritable bowel (IB), chronic fatigue (CF), multiple chemical sensitivity (MCS), and whiplash-associated disorder (WAD).
Participants (n = 7493) from the population-based cohort Danish Study of Functional Disorders (DanFunD) completed questionnaires on FSD, emotional distress, SA, and sociodemographics. Risk ratios (RRs) for each FSD and emotional distress were calculated in nine models with SA as the primary exposure using generalized linear models with binomial family and log link and were adjusted for other potential risk factors.
The results showed that SA was associated with single-organ FSD (RR = 1.51; 95% CI = 1.22–1.87), multi-organ FSD (RR = 3.51; 95% CI = 1.89–6.49), CWP (RR = 1.28; 95% CI = 0.83–1.98), IB (RR = 2.00; 95% CI = 1.30–3.07), CF (RR = 1.81; 95% CI = 1.42–2.32), WAD (RR = 2.62; 95% CI = 1.37–5.03), MCS (RR = 3.04; 95% CI = 1.79–5.17), emotional distress (RR = 1.75; 95% CI = 1.21–2.54), and health anxiety (RR = 1.65; 95% CI = 1.10–2.46).
Overall, SA victims experienced significantly more somatic symptoms than individuals not exposed to SA. Adjusting for physical and emotional abuse did not change the observed associations. Our results suggest a large impact of SA on the overall somatic and mental health of SA victims. Due to the cross-sectional study design, further studies are required.
10. Cognitive profile in functional disorders
Eka Roivainen, Maria Peura & Jukka Pätsi.
Cognitive Neuropsychiatry.
Abstract
Introduction: Patients with functional disorders (FD) often experience cognitive problems such as forgetfulness and distractibility alongside physical symptoms that cannot be attributed to a known somatic disease.
Method: Test scores of cognitive tests and psychiatric rating scales of 100 outpatients diagnosed with a functional disorder were compared to a control group (n = 300) of patients with other diagnoses and to test norms for the general population.
Results: Out of the 100 patients with functional disorders, 59 reported significant subjective cognitive symptoms. A moderate difference (d = 0.5-0.7) was found between the FD group mean and the population mean in processing speed tests, as well as in four psychiatric rating scales (depression, anxiety, phobias, somatisation) but there were no statistically significant differences in verbal and nonverbal reasoning or in logical memory. Somatisation and logical verbal memory scores were higher in the FD group compared to the control group.
Conclusion: The findings of the study suggest that a decline in processing speed is a central feature in the cognitive profile of patients with functional disorders.
Miwa K and Inoue Y.
IBRO Neuroscience Reports (2023).
Highlights
- Repetitive transcranial magnetic stimulation (rTMS) was applied to the brain in patients with myalgic encephalomyelitis.
- After therapy, the restriction of activity of daily living was ameliorated in most patients.
- rTMS alleviated various symptoms, especially orthostatic intolerance and disequilibrium.
Abstract
Background: Central nervous system dysfunction has been postulated to cause debilitating symptoms in patients with myalgic encephalomyelitis (ME) (originally called “chronic fatigue syndrome”). Repetitive transcranial magnetic stimulation (rTMS) is a newly developed neuromodulatory procedure and has been suggested to facilitate the cortical neural activity.
Methods: This study enrolled 30 patients with ME (7 men and 23 women) with a mean age of 39±12 years, who received rTMS treatment of both the left dorsolateral prefrontal cortex and the left primary motor area in the brain. The performance status score (0–9) for restricting activities of daily living, orthostatic intolerance (OI) during a 10-min standing test, neurologic disequilibrium diagnosed as unstable standing with their feet together and eyes closed, neuropathic pain or fibromyalgia, and muscle weakness were compared before and after treatment.
Results: After therapy, favorable effects were observed with a decrease in performance status score or index for restriction of activities of daily living of ≥2 points in 20 patients (67%). OI with the inability to complete the 10-min standing test was resolved in 10 (83%) out of 12 patients, and disequilibrium was resolved in 15 (88%) out of 17 patients. Neuropathic pain or fibromyalgia was attenuated in seven (70%) out of 10 patients. Muscle weakness with grip power of <10 kg was resolved in two (50%) out of four patients. No untoward effects were encountered in all the study patients.
Conclusion: The treatment with rTMS is effective in alleviating various symptoms, especially OI and disequilibrium, and in improving the activities of daily living in patients with ME.
12. Persistent burnout theory of ME/CFS
Jameson D.
PsyArXiv, 22 Oct. 2023. [Preprint]
Abstract
There is no agreement on the etiology of myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS), and the main theories (behavioural and viral/immune) do not satisfactorily explain the condition. A growing body of evidence suggests that ME/CFS may be caused by a dysfunction of the stress system—the autonomic nervous system (ANS) and hypothalamic–pituitary–adrenal (HPA) axis in particular—as a result of chronic stress. ME/CFS shares many similarities to occupational burnout and overtraining syndrome, including similar symptoms, physiological abnormalities, and triggers.
After a brief review of the science of stress, burnout, overtraining, central fatigue, and ME/CFS, we propose a model of ME/CFS based on a state of persistent burnout that remains after the initial stressors have been removed. This persistence may be due to a combination of a dysregulation of the ANS and HPA axis, behavioural factors, and negative feedback from the illness itself.
Long-COVID Research References
- Immunological profiling in long COVID: overall low grade inflammation and T-lymphocyte senescence and increased monocyte activation correlating with increasing fatigue severity
- Risk factors associated with post-acute sequelae of SARS-CoV-2: an N3C and NIH RECOVER study
- The remote diet intervention to reduce Long COVID symptoms trial (ReDIRECT): protocol for a randomised controlled trial to determine the effectiveness and cost-effectiveness of a remotely delivered supported weight management programme for people with Long COVID and excess weight, with personalised improvement goals
- Prevalence of Long-term Symptoms Varies When Using Different Post-COVID-19 Definitions in Positively and Negatively Tested Adults: The PRIME Post-COVID Study
- From brain fog to COVID toe: A head-to-toe review of long COVID
- Long-term health impacts of COVID-19 among 242,712 adults in England
- Post-COVID-19 syndrome: Physical capacity, fatigue and quality of life
- Serological Biomarkers at Hospital Admission and Hospitalization Treatments Are Not Related to Sensitization-Associated Symptoms in Patients with Post-COVID Pain
- A Review Article on Exercise Intolerance in Long COVID: Unmasking the Causes and Optimizing Treatment Strategies
- Atopy and Elevation of IgE, IgG3, and IgG4 May Be Risk Factors for Post COVID-19 Condition in Children and Adolescents
- Long-COVID is Associated with Impaired Red Blood Cell Function
- Prevalence of sleep disturbances in patients with long COVID assessed by standardised questionnaires and diagnostic criteria: A systematic review and meta-analysis
- Cognitive Impairment and Risk Factors in Post-COVID-19 Hospitalized Patients
- “It was almost like it's set up for people to fail” A qualitative analysis of experiences and unmet supportive needs of people with Long COVID
- Long Covid: A New Challenge for Healthcare Systems and Family Medicine Practice
- Cardiovascular dysautonomia in postacute sequelae of SARS-CoV-2 infection
- Navigating the Post-COVID-19 Immunological Era: Understanding Long COVID-19 and Immune Response
- Sequential multi-omics analysis identifies clinical phenotypes and predictive biomarkers for long COVID
- Exploring the Influence of Pre-Existing Conditions and Infection Factors on Pediatric Long COVID Symptoms and Quality of Life
- Examining the relationship between inflammatory biomarkers during COVID-19 hospitalization and subsequent long-COVID symptoms: A longitudinal and retrospective study
- Neuroinflammation in post-acute sequelae of COVID-19 (PASC) as assessed by [ 11 C]PBR28 PET correlates with vascular disease measures
- Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection
- The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID
- Patient experiences of the long COVID-Optimal Health Programme: qualitative interview study in community settings
- Gaps in benefits, awareness, and comprehension that leave those with long COVID vulnerable
- The association of insomnia with long COVID: An international collaborative study (ICOSS-II)
Dr Katrina Pears,
Research Correspondent.
The ME Association.
