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News Medical: Long COVID and ME/CFS patients could benefit from a coordinated treatment strategy

News Medical Life Sciences

Given the important clinical and pathological overlaps between ME/CFS and Long Covid co-ordinated research is something that the MEA has been calling for since May 2020 – when it became clear that Covid-19 was also triggering a post viral disease with symptoms that were identical to those found in ME/CFS

Sadly, it has taken over three years for many of the researchers involved in Long Covid research to accept that these overlaps occur

However the message is now getting through 

Hopefully, this will lead to a better understanding of what causes post viral disease and the development of effective forms of treatment aimed at the underlying disease process in both Long Covid and ME/CFS

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

Extracts

People suffering from Long COVID or Myalgic Encephalomyelitis /Chronic Fatigue Syndrome (ME/CFS) could benefit from a coordinated treatment strategy, a new University of Otago study has found.

The pilot study, published in Scientific Reports, a Nature journal, has confirmed what researchers have suspected for some time: the two conditions are closely related.

Lead author Emeritus Professor Warren Tate says the research – the first comparative molecular study of the immune cell proteins of both conditions – “strongly affirms” the link between the two.

“This means information from study of the pathophysiology of ME/CFS and therapeutic opportunities that have slowly accumulated over the last 30 years can be transferred to understanding and treating the now estimated 100 million cases of Long COVID world-wide.

“But equally important, the immense resources put into Long COVID research currently in the rich nations, while yet to produce major breakthroughs, can also benefit the many millions of ‘hidden' ME/CFS patients whose numbers have increased steadily over time in the absence of their recovery from the illness.”

Study results showed the immune system activity of six Long COVID patients one year after a COVID-19 infection was dramatically different from five healthy controlled-group study participants, reflecting a chronic dysfunctional state.

The study reinforces the researchers' previously published model in Frontiers of Neurology to explain the complex dysfunctional physiology for both ME/CFS and Long COVID: In susceptible people (determined by their health history and genetic background), the normal transitory immune/inflammatory response of the peripheral nervous system to infection or stress does not resolve quickly as in most people.

Instead, it becomes chronic and leads to a cascade effect involving the brain, immune system and central nervous system, which in turn results in multiple neurological symptoms and poor brain regulation of body physiology.

Emeritus Professor Tate says Long COVID from the pandemic SARS-CoV-2 virus is a specific example of ME/CFS, that has occurred in susceptible people from endemic viruses like glandular fever, and from small historical viral outbreaks geographically contained like the SARS-CoV-1 virus outbreak in 2003.

“It highlights within our community there are significant numbers of people debilitated now with disrupted immune systems, dysfunctional energy production, and disturbed brain regulation of their overall physiology that severely disrupts their family lives, ability to work and participate in their communities long-term, and that these people need support from all levels of society.”

Investment in combined clinical trials to treat both conditions is desperately needed, he says.

Emeritus Professor Tate is calling for national guidelines with best practice disease management plans for clinicians so both patient groups have a good chance of a more fulfilling life no matter the stage of their illness, although he points out this must be accompanied by specialist clinics with a range of practitioners to support the patient's need

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