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Symptom Overlap in Long COVID and Myalgic Encephalomyelitis

Myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), is a medical condition that typically affects someone’s nervous system, immune function, and gastrointestinal tract. Its symptoms exist on a wide spectrum and their severity and development vary from one individual to another.

Long COVID consists of a persistence of symptoms following the end of a COVID-19 infection, Like ME/CFS, the condition can present many different symptoms that are difficult to predict. A significant number of symptoms overlaps with those of ME/CFS, which has prompted increased interest in medical research for both conditions.

Researchers and physicians may apply existing research, treatment protocols, and possible treatment for ME/CFS to long COVID.

Cognitive Impairment

Many people with long COVID report “brain fog” and other cognitive difficulties, which is similar to various ME/CFS challenges. Heightened depression and anxiety may occur as part of this symptom category.

Common cognitive impairments for those conditions include:

  • Trouble focusing
  • Memory issues
  • Autonomic dysfunction
  • Changes in pain and sensory perceptions
  • Sleep disorders

Medical imaging, especially MRI, can help identify brain anatomical and neurochemical modifications in people with ME/CFS, and possibly in upcoming research on long COVID. MRI can play an important role in understanding pathology mechanisms in neurological conditions.

Gastrointestinal Disturbances

Many people with ME/CFS and long COVID report gastrointestinal symptoms such as:

  • Abdominal pain
  • Constipation
  • Diarrhea
  • Irritable bowel
  • Nausea

Both conditions can also result in issues with the nerves and muscles along the gastrointestinal tract and/or an imbalance in gut bacteria. A possible cause for those symptoms is dysregulated gut-brain signaling, which would tie in with other neurological and cognitive symptoms.

Immune Dysfunction

Associated with nervous and gastrointestinal issues, immune dysfunction is a common symptom of both ME/CFS and long COVID. ME/CFS often chronic immune activation, which can look like swollen lymph nodes. Most studies consider ME/CFS as a neuroimmune condition rather than an autoimmune one although research may indicate that immune cell exhaustion occurs with ME/CFS, which can make the person more likely to develop an infection. This cell exhaustion problem has also happened in long COVID patients.

Current Results and Hypothesis for ME/CFS and Long Covid

Studies have pointed toward the likelihood that both conditions involve mitochondrial dysfunction. This may involve changes in DNA structure, respiratory function, and specific blood and immune cells. If confirmed as a biomarker with additional research, mitochondrial dysfunction could explain several ME/CFS and long COVID symptoms, especially those related to cell and immune exhaustion.

Another possible biomarker for both conditions is calcium signaling. Calcium supports many bodily functions and cell processes, including gastrointestinal, cognitive, and immune functions. Although studies are still in their infancy compared to those on mitochondrial dysfunction, there is potential.

The Challenges of ME/CFS and Long Covid Research

Identifying the underlying mechanism of ME/CFS encounters many challenges such as:

  • A small number of internationally recognized treatment options
  • Limited improvement said treatments provide
  • Insufficient evidence of medication results and side effects
  • Too broad study criteria
  • Inconsistent protocols

Inconsistent funding can also negatively impact the research although the discovered overlap between ME/CFS and long COVID symptoms offers new opportunities and interest for future studies. This overlap between both conditions also raises questions such as how to identify each one, and does one condition increases the risk of developing the other.

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