Weeks and months of symptom persistence among post-COVID-19 patients testing negative has prompted research into mechanisms underlying myalgic encephalomyelitis / chronic fatigue syndrome and other chronic post-viral illnesses.
...In two recent reports — one published in the Journal of the American Medical Association in July and another published in Morbidity and Mortality Weekly Report this month — chronic fatigue was listed as the top [persisting] symptom...
Although [cough, chest pain, and dyspnea] appear specific to SARS-CoV-2 … [other symptoms reiterate] the diagnostic criteria for ME/CFS, which is defined by substantial, profound fatigue for at least 6 months, post-exertional malaise, unrefreshing sleep, and one or both of orthostatic intolerance and/or cognitive impairment. Although the etiology of ME/CFS is unclear, the condition commonly arises following a viral illness.,,,
source: Medscape (a professional site
free to the public with registration)
On August 21, the International Association for Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (IACFS/ME)’s annual conference met via Zoom, opening with this topic. IACFS/ME co-vice-president Lily Chu, MD remarked that much of the research on ME/CFS may provide insight for this COVID-19 issue, present COVID-19 findings may lluminate how CF/ME arises and develops (cf. wikipedia article section on etiology of cfs), and indicate whether a patient with persistent COVID-19 symptoms might be progressing to ME/CFS. (Another shared symptom is persistent pain.)
At the conference, longtime ME/CFS researcher Harvey Moldofsky, MD —Department of Psychiatry (Emeritus) at the University of Toronto, Canada— addressed a certain sense of déjà vu with review of the
data from a previously published case-controlled study, which included 22 healthcare workers who had been infected in 2003 with SARS-CoV-1 and continued to report chronic fatigue, musculoskeletal pain, and disturbed and unrefreshing sleep with EEG-documented sleep disturbances 1 to 3 years following the illness. None had been able to return to work by 1 year.
Dr Chu advocated teaching post-COVID-19 syndrome patients the CFS/ME pacing techniques for balancing necessary life activities with rest at intervals across their day, in order to conserve energy and avoid destructive “push/crash” episodes. (Among that list, note this from the CDC and this in connection with the same phenomenon in fibromyalgia; see also this PubMedCentral quick-search.)
She emphasized not delaying teaching this until the classic ME/CFS 6-month point — “the data seem to be pointing to deficiencies in producing energy" — these techniques cannot do harm, they facilitate natural increased activity if/when improvement occurs with any chronic health deficit involving unusual fatigue, and if ME/CFS does set in then the patient has acquired valuable a valuable set of life-skills for coping.
Objective measures of ME/CFS include low natural killer cell function (the test can be ordered from commercial labs but requires rapid transport of the blood sample), and autonomic dysfunction assessed by a tilt-table test.
Additional topics touched upon:
- research into risk factors for developing ME/CFS in college students who contracted infectious mononucleosis as a result of Epstein-Barr virus. — those students are being followed-up now for those who develop COVID-19.
- the Open Medicine Foundation (OMF) has funded a project to follow-up with patients discharged from the intensive care unit following severe COVID-19 illness.
-
the Solve ME/CFS initiative has developed a new plan to use their registry to prospectively track the impact of COVID-19 on people with ME/CFS, in concert with "Long-COVID" communities including Body Politic, “a queer feminist wellness collective...”
<big><big>Aside from this conference and the links in this diary,</big></big> readers who keep up with professional medical literature will have observed a growing consensus that national and global populations of long-term and permanently disabled people are increasing and will continue to, as a direct consequence of this pandemic, and indirectly as well.
The overwhelming majority of the disabled will face lethal economic challenges to survival in countries that cannot recognize the crucial necessity of mitigating misery in order to conserve productivity and advance simple human civilization … or that could but decline to. Even in countries that can and do possess that recognition, the healthcare systems as a continuum —encompassing medical care and societal support for wellbeing against poverty, racism, environmental degradation and conflict— will be forever changed in the scope responsibilities to shoulder, and the demands made upon entire populations, the moderately privileged and the highly privileged alike.
Read more at the source article and the rest of Medscape’s resources — registration at Medscape is free, there is no paywall of any kind. UPDATE: related articles:
- Medscape First Evidence of SARS-CoV-2 in Heart Cells;
- KHN.org: ■ First case of a person contracting COVD19 twice is documented ■ MASK UP OR PACK UP: One college’s pop-up COVID test: stop and smell the roses/coffee, adhere to all rules, or go.
- California Healthline.org ■ Wildfires provide another reason to mask up.
Click on tags of interest in the top left margin to find more DK diaries. Click on the dk group Pain Patient Empowerment in the <small>PUBLISHED TO</small> section, and dk’s KosAbility tag and group. Apologies if I turn out unable to respond optimally in the comment thread.
Take care of one another.
Stronger together.
