What if long Covid is not a form of Covid-19, but an expression of a more comprehensive multisystem disease?
Since Covid or post-Covid was recognized three years ago, little progress has been made in prevention, diagnosis and treatment. However, this post-virus condition still very much exists today. About 5% of Covid patients develop long Covid disease, long after SARS-CoV-2 has disappeared from the body. Women, young people and active populations are usually mainly affected.
As the world returns to normal after the acute phase of the pandemic, up to 65 million people worldwide have fallen victim to post-Covid syndrome, which can manifest itself in the form of about 200 symptoms: fatigue, headaches, problems with memory and concentration, muscle pain and sleep disorders.
Patients have no idea what is going on in their bodies and feel misunderstood by the medical world and society. After all, we as a society cannot cope well with the phenomenon of “forever sick”, which also affects patients with, for example, chronic fatigue syndrome (CFS). Are long Covid and chronic fatigue syndrome the same disease?
What is chronic fatigue syndrome
Chronic fatigue syndrome (CFS) is an invisible multisystem disease that has been on the medical radar for more than 50 years, but its cause remains unknown. Even before doctors became aware of this phenomenon in the 1970s, the global emergency of HIV/AIDS caught their attention and research into chronic fatigue syndrome stalled.
Meanwhile, the medical literature talks about “myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS),” a label that suggests it’s more than just fatigue, but serious physical complaints and a kind of fatigue for which there seems to be no word. In Dutch. ME literally means “inflammation of the spinal cord.”
Symptoms of ME/CFS are abnormal and complete fatigue that does not go away with sleep or rest, exercise intolerance or malaise after exertion, muscle pain, migraine attacks, balance and sleep disturbances, sensitivity to light and noise, and mental fatigue, so-called. Brain fog Or brain fog.
Previous infections and inflammations are likely to be the cause. Many viruses, such as the Epstein-Barr virus, which causes glandular fever, and the coronavirus are harmless to most people, but they cause a lot of misery to others. Bacterial diseases such as Lyme disease and Q fever can also cause ME/CFS. But viruses don’t always play a role: fibromyalgia is also a form of chronic fatigue syndrome.
Is long Covid the same as ME/CFS?
It is not yet clear whether long Covid and ME/CFS are the same. Every now and then scientists discover certain mechanisms that play a role in long Covid, but they go in all directions. There is also no consensus yet on the definition of long Covid, making it difficult to compare the condition to other diseases.
However, in terms of symptoms, there are striking similarities. About 75 percent of long Covid patients are said to show signs of ME/CFS. The other 25 percent have specific damage to an organ or body system from the virus itself or from another disease resulting from the infection.
The longer the coronavirus persists, the more symptoms begin to resemble ME/CFS, such as exercise intolerance, fatigue, cognitive problems, and sleep problems. But unlike ME/CFS, long Covid symptoms can go away again. Think loss of sense of smell and taste and respiratory problems.
American virologist Anthony Fauci also sees similarities, but there is also an important difference: Long Covid depends on a specific virus and it is clear when the infection occurred. This is not usually the case with ME/CFS. In the latter case, antibodies against different viruses can be detected, but it cannot be determined when infection occurred.
Meanwhile, billions are being invested in biomedical research into treating long Covid, but the pieces of the puzzle are not yet complete. More and more scientists believe the focus of the research is wrong: Long Covid is not Covid-19, but rather COVID-19. ME/CFS form. “Long Covid is actually a new name for an old syndrome” To write Stephen Phillips of the Global Virus Network and Harvard epidemiologist Michelle Williams.
SARS-CoV-2 infection does not cause ME/CFS, but it can lead to illness, for example in people who are more susceptible to infection due to genetic predisposition. If these people become infected with a viral infection, many functions and organ systems are disrupted in one way or another. The elicited response may be triggered by the virus itself, by the severity of the disease, by reactivation of underlying pathogens, or by a combination of all of these factors.
Should we talk about ME/CFS/long covid from now on?
According to Phillips and Williams, combining post-viral complaints into a new paradigm is the key to achieving a new method of scientific research. Because the study of ME/CFS is also a blind spot in medicine. How did this happen? There is simply nothing to be found using current scientific tools.
Does this mean that the disorders are “in your head”? never. ME/CFS/long covid does exist, but the debate about the “realism” of post-infectious fatigue syndromes is false because it suggests a dichotomy between biological and psychological components, when in reality the two go together. Research should no longer focus on biomarkers and causes in the body, but rather on treatments that directly affect patients’ health. Prevention, early detection, symptom management and compassionate multidisciplinary care are even more important for the patient in this regard. For example, people with post-infectious syndromes have a better chance of recovery and improvement if the disease is detected early.
Will there soon be a boom in research into long Covid?
Would we have an answer to long Covid today if ME/CFS had not been overlooked in science in the past? maybe. But thanks to Long Covid, post-virus conditions are now getting much more attention. The large pool of long Covid patients allows for large-scale studies to be initiated. There is no doubt that the results of long Covid studies are relevant to ME/CFS and vice versa. So the wheel must be reinvented.
More information: Post Covid.be
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