Images of research to illustrate the weekly research roundup

ME/CFS Research Published 26 December 2023 – 1 January 2024 

The weekly research round-up includes recent publications about ME/CFS and Long Covid. We highlight studies that have particularly caught our attention.


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 surprisingly busy week for research, despite it being the Christmas period. There has been a huge variety in the studies this week, with ten new ME/CFS studies and twenty-seven new Long Covid studies. Unfortunately, numerous studies this week appear to be behind a paywall. 

We have also included the ME/CFS references for the previous week, 18-26 December 2023, where there were four new studies published. 

We have highlighted one of the ME/CFS studies in more detail below: 

Paper two (2) looks into the immunological dysfunction in ME/CFS and Long Covid and treatment with a nebulized antioxidant/anti-pathogen agent. The study included 12 patients with ME/CFS, 8 with Long Covid and 10 healthy controls. 

The researchers firstly assessed the CD8 T cell dysfunction by developing a functional assay by intracellular cytokine staining (ICS). They also assessed symptom severity through questionnaires which were developed for the purpose of this study. These were then combined to assess the response to the treatment provided in a subset of patients (4 ME/CFS and 4 Long Covid). 

  • CD8 T cells are lymphocytes, that are an important arm of the antiviral immune response. They kill virus infected cells and produce antiviral cytokines, they contribute to resisting primary and secondary infections. 

The treatment used was a nebulized antioxidant/anti-pathogen agent, Inspiritol. It was initially developed to treat major symptoms of respiratory distress through an agent with combined antioxidant, anti-inflammatory, and broad-spectrum antiviral, antifungal and antibacterial properties. It is a sterile isotonic pH-balanced liquid suspension with four ingredients: two endogenously produced compounds (glutathione and methylcobalamin); one repurposed prescription drug that is a pro-drug to an endogenously produced amino acid (N-acetylcysteine); one plant extract monoterpene cyclic ether (1,8-cineole) and one natural bicyclic sesquiterpene (β-caryophyllene), in a proprietary liquid carrier.  

The ingredients have been reported to relieve oxidative stress, attenuate NF-κB signaling, and/or to act directly to inhibit pathogens, including viruses. These well-studied antioxidants and agents with anti-pathogen potential were administered to the lungs; components of this nebulized agent are also likely to be distributed systemically, with potential to enter the central nervous system. 

Some of the key findings: 

  • Both Long COVID and ME/CFS are characterized by dysfunctional CD8 T-cells with severe deficiencies in their abilities to produce the cytokines, IFNγ and TNFα. 
  • The results showed CD8 T-cell dysfunction indicative of some aspects of T-cell clonal exhaustion, a phenomenon associated with oxidative stress. 
  • The symptom severity questionnaire showed similar symptom profiles for both ME/CFS and Long Covid. 
  • For the patients that underwent treatment, patients' immune deficiency and health improved during the treatment period with the nebulized agent. 
  • For the patients that underwent treatment, there was an increase in CD8 T-cell IFNγ and TNFα production and a decrease in overall self-reported symptom severity score by 54%. 
  • All 8 patients had a positive response. 
  • No serious treatment-associated side effects or laboratory anomalies were noted in these patients. 
  • The authors suggest that this work provides evidence of a useful biomarker, CD8 T-cell dysfunction reminiscent of T cell exhaustion, that may assist diagnosis and have utility for tracking disease outcome during therapy, including response to a potential new treatment. 

There are some interesting results in this study, which further show the similarities between ME/CFS and Long Covid. A few further things to point out about this study: 

  • ME/CFS was diagnosed by the Institute of Medicine Criteria. 
  • This study was primarily a retrospective case series report and details the 8 patients who received the treatment (nebulized agent). Detailed patient characteristics and descriptions of 1 ME/CFS and 1 Long Covid patient are listed within the study. 
  • Patients took the nebulized agent for different periods of time, dependent upon the rate of improvement in symptom severity. This varied from 3 to 15 months. 
  • A further subsection of the patients receiving the nebulized agent also took an antiviral treatment, such as valacyclovir (VLX), valganciclovir (VLC), spironolactone (SPLT). Meaning it is difficult to truly compare patients. 
  • The results show that intervening with Long Covid patients in the earlier stages of illness has a great potential to improve the disease course, compared to those with later stages or more chronic ME/CFS. 
  • Some previous information on the research of the nebulized agent, Inspiritol, can be found on the Science for ME forum (here). 

This is expressed by the authors to only be a preliminary study. The treatment suggested alone would need significantly more studies, which would need to be conducted in double-blinded controlled trials. This is also one of the few studies where biological measures are used to assess treatment response. 

ME/CFS Research References  

  1. Assessing symptoms of long/post COVID and chronic fatigue syndrome using the DePaul symptom questionnaire-2: a validation in a German-speaking population 
  1. Identification of CD8 T-cell dysfunction associated with symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID and treatment with a nebulized antioxidant/anti-pathogen agent in a retrospective case series 
  1. Subcortical and Default Mode Network connectivity is impaired in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome 
  1. Why the Psychosomatic View on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Is Inconsistent with Current Evidence and Harmful to Patients 
  1. Exploring the neurocognitive consequences of post-exertional malaise in myalgic encephalomyelitis 
  1. Dysregulation of the autonomic nervous system in ME/CFS and post-COVID syndrome: insights from 48-h heart rate variability monitoring 
  1. Heterogenous circulating miRNA changes in ME/CFS converge on a unified cluster of target genes: A computational analysis 
  1. Long COVID-19 and post-viral chronic fatigue syndrome (CFS/ME): Similarities and differences 
  1. A 6-month Ibudilast treatment regimen aimed to improve brain function in ME/CFS patients: A case study 
  1. How Patient Input Helped Create Culturally Sensitive Multinational Instruments Assessing Post Viral Symptoms 

ME/CFS Research References (18-26 December 2023) 

  1. Functional Somatic Syndromes Are Associated With Varied Postoperative Outcomes and Increased Opioid Use After Spine Surgery: A Systematic Review 
  1. Effectiveness of an online multicomponent program (FATIGUEWALK) for chronic fatigue syndrome: A randomized controlled trial 
  1. Investigating the Human Intestinal DNA Virome and Predicting Disease-Associated Virus-Host Interactions in Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) 
  1. Cost-Effectiveness of Online Cognitive Behavioral Therapy for Children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) Compared to Online Activity Management: FITNET-NHS Trial Findings 

Long-COVID Research References (26 December 2023 – 1 January 2024) 

  1. Urine Metabolite Analysis to Identify Pathomechanisms of Long COVID: A Pilot Study 
  1. Impact of Long COVID on productivity and informal caregiving 
  1. Long Covid Perspectives: history, paradigm shifts, global challenges 
  1. Long Covid, the Gut, and Autoimmune Skin Diseases: A Novel Therapeutic Approach 
  1. Treatment of long COVID complicated by postural orthostatic tachycardia syndrome—Case series research 
  1. Analysis of post-COVID symptoms and predisposing factors for chronic post-COVID syndrome 
  1. Smartphone-based evaluation of static balance and mobility in long-lasting COVID-19 patients 
  1. The impact of long COVID on health-related quality of life in patients 6 months after discharge with severe COVID-19 
  1. Post-COVID-19 Condition in Children 6 and 12 Months After Infection 
  1. Post-acute COVID-19 neuropsychiatric symptoms are not associated with ongoing nervous system injury 
  1. A Survey on the Role of Artificial Intelligence in Managing Long COVID 
  1. Nutritional and Wellness Strategies for Neurological and Psychiatric Recovery From PostCOVID Syndrome and Post-acute Sequelae of COVID-19 
  1. Development & Validation of Yoga Based Intervention for Elders with Long Covid 
  1. Clinical features of postcovid syndrome 
  1. What do infectious disease specialists think about managing long COVID? 
  1. Arterial Stiffness and Oxidized LDL Independently Associated With Post-Acute Sequalae of SARS-CoV-2 
  1. Long COVID: Molecular Mechanisms and Detection Techniques 
  1. Cannabinoids and the Endocannabinoid System in Early SARS-CoV-2 Infection and Long COVID-19—A Scoping Review 
  1. Long COVID is not a uniform syndrome: Evidence from person-level symptom clusters using latent class analysis 
  1. Dermatologic Changes in Experimental Model of Long-COVID 
  1. New Alcohol Sensitivity in Patients With Postacute Sequelae of SARS-CoV-2 (PASC): A Case Series 
  1. Fatigue can influence the development of late-onset pain in post-COVID-19 syndrome: An observational study 
  1. Cardiovascular autonomic dysfunction in post-COVID-19 syndrome: a major health-care burden 
  1. Long COVID in Persons With Self-Reported Arthritis: Symptoms, Associated Factors, and Functional Limitations 
  1. Ethnic and Individual Variations in Long COVID-19 Symptoms 
  1. Intranasal ketamine as a treatment for psychiatric complications of long COVID: A case report 
  1. Gut Microbiome Composition and Dynamics in Hospitalized COVID-19 Patients and Patients with Post-Acute COVID-19 Syndrome 

Dr Katrina Pears,
Research Correspondent.
The ME Association.

Dr Katrina Pears - MEA Research Correspondent



Shopping Basket