Long COVID science, research and policy

Nature Medicine, Journal Year: 2024, Volume and Issue: 30(8), P. 2148 - 2164

Published: Aug. 1, 2024

Long COVID represents the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection; it is a complex, multisystem disorder that can affect nearly every organ system be severely disabling. The cumulative global incidence long around 400 million individuals, which estimated to have an annual economic impact approximately $1 trillion-equivalent about 1% economy. Several mechanistic pathways are implicated in COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement endothelial inflammation microbiome dysbiosis. devastating impacts on individual lives and, due its complexity prevalence, also has major ramifications for systems economies, even threatening progress toward achieving Sustainable Development Goals. Addressing challenge requires ambitious coordinated-but so far absent-global research policy response strategy. In this interdisciplinary review, we provide synthesis state scientific evidence assess human health, systems, economy metrics, forward-looking roadmap.

Language: Английский

---

Cardiopulmonary and metabolic responses during a 2-day CPET in myalgic encephalomyelitis/chronic fatigue syndrome: translating reduced oxygen consumption to impairment status to treatment considerations

Journal of Translational Medicine, Journal Year: 2024, Volume and Issue: 22(1)

Published: July 5, 2024

Abstract Background Post-exertional malaise (PEM), the hallmark symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), represents a constellation abnormal responses to physical, cognitive, and/or emotional exertion including profound fatigue, cognitive dysfunction, and intolerance, among numerous other maladies. Two sequential cardiopulmonary exercise tests (2-d CPET) provide objective evidence in ME/CFS but validated only studies with small sample sizes. Further, translation results impairment status approaches reduction are lacking. Methods Participants (Canadian Criteria; n = 84) sedentary controls (CTL; 71) completed two CPETs on cycle ergometer separated by 24 h. Two-way repeated measures ANOVA compared CPET at rest, ventilatory/anaerobic threshold (VAT), peak effort between phenotypes CPETs. Intraclass correlations described stability across tests, relevant data indicated status. A subset case–control pairs (n 55) matched for aerobic capacity, age, sex, were also analyzed. Results Unlike CTL, failed reproduce CPET-1 during CPET-2 significant declines work, time, $$\dot{\text{V}}$$ V ˙ e, O 2 , CO T HR, pulse, DBP, RPP. Likewise, observed VAT e/ PetCO 2, SBP. Perception (RPE) exceeded maximum criteria CTL both similar pairs. revealed greater variables test days owing ME/CFS. Lastly, signaled more severe CPET-1. Conclusions Presently, this is largest 2-d study substantiate impaired recovery following an exertional stressor. Abnormal post-exertional persisted indicating that fitness level does not predispose intolerance Moreover, contributions disrupted cardiac, pulmonary, metabolic factors implicates autonomic nervous system dysregulation blood flow oxygen delivery energy metabolism. The observable metabolism translate notably worsening Treatment considerations address tangible reductions physiological function proffered. Trial registration number: ClinicalTrials.gov, retrospectively registered, ID# NCT04026425, date registration: 2019-07-17.

Language: Английский

---

Epigenetic reprograming in myalgic encephalomyelitis/chronic fatigue syndrome: A narrative of latent viruses

Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: 296(1), P. 93 - 115

Published: May 1, 2024

Abstract Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic disease presenting with severe fatigue, post‐exertional malaise, and cognitive disturbances—among spectrum of symptoms—that collectively render the patient housebound or bedbound. Epigenetic studies in ME/CFS confirm alterations and/or malfunctions cellular organismal physiology associated immune responses, metabolism, cell death proliferation, neuronal endothelial function. The sudden onset follows major stress factor that, approximately 70% cases, involves viral infection, symptoms overlap those long COVID. Viruses primarily linked to pathology are symbiotic herpesviruses, which follow bivalent latent–lytic lifecycle. complex interaction between viruses hosts strategies from both sides: evasion persistence by viruses, activation clearance host. This dynamic imperative for herpesviruses that facilitate their through epigenetic regulation own host genome. In current article, we provide an overview signatures demonstrated focus on potential latent viruses—particularly Epstein–Barr virus—may employ long‐term reprograming ME/CFS. could aid elucidating relevant biological pathways impacted reflect physiological variations among patients stem environmental triggers, including exogenous altered activity.

Language: Английский

---

Research progress on pathogenesis of chronic fatigue syndrome and treatment of traditional Chinese and Western medicine

Autonomic Neuroscience, Journal Year: 2024, Volume and Issue: 255, P. 103198 - 103198

Published: July 8, 2024

Chronic Fatigue Syndrome (CFS) is a complex and perplexing medical disorder primarily characterized by persistent debilitating fatigue, often accompanied constellation of symptoms, including weakness, dyspnea, arthromyalgia, sore throat, disrupted sleep patterns. CFS defined its or recurrent manifestation for minimum duration six months, marked an enduring unrelenting fatigue that remains refractory to rest. In recent decades, this condition has garnered significant attention within the community. While precise etiology elusive, it postulated be multifactorial. potentially associated with various contributory factors such as infections, chronic stress, genetic predisposition, immune dysregulation, psychosocial influences. The pathophysiological underpinnings encompass viral system neuroendocrine aberrations, heightened oxidative perturbations in gut microbiota. Presently, clinical management predominantly relies on pharmaceutical interventions singular therapeutic modalities, offering alleviation specific symptoms but exhibiting inherent limitations. Traditional Chinese Medicine (TCM) have emerged promising paradigm, demonstrating notable efficacy through their multimodal, multi-target, multi-pathway approach, holistic regulatory mechanisms. These effectively address lacunae contemporary interventions. This comprehensive review synthesizes advancements understanding etiological factors, mechanisms, interventional strategies CFS, drawing from corpus domestic international literature. Its aim furnish valuable insights clinicians actively involved diagnosing treating well researchers delving into innovative drug development pathways. Moreover, seeks intricate challenges confronted practitioners managing incapacitating condition.

Language: Английский

---

Cognitive Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome—Aetiology and Potential Treatments

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(5), P. 1896 - 1896

Published: Feb. 22, 2025

Systemic infection and inflammation impair mental function through a combination of altered attention cognition. Here, we comprehensively review the relevant literature report personal clinical observations to discuss relationship between infection, peripheral inflammation, cerebral cognitive dysfunction in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Cognitive ME/CFS could result from low-grade persistent associated raised pro-inflammatory cytokines. This may be caused by both infectious non-infectious stimuli lead regional blood flow accompanied disturbed neuronal function. Immune dysregulation that manifests as subtle immunodeficiency or autoimmunity targeting one more receptors also contributing factor. Efforts reduce systemic viral reactivation improve mitochondrial energy generation have potential this highly disabling condition.

Language: Английский

---

Mechanism of Traditional Chinese Medicine in the Treatment of Chronic Fatigue Syndrome Based on Gut Microbiota

Advances in Clinical Medicine, Journal Year: 2024, Volume and Issue: 14(09), P. 679 - 683

Published: Jan. 1, 2024

Language: Английский

---

Epidemiology of Myalgic Encephalomyelitis among individuals with self-reported Chronic Fatigue Syndrome in British Columbia, Canada, and their health-related quality of life

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: May 16, 2024

ABSTRACT Background There is no accurate data on the epidemiology of Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) in Canada. The aims study were to describe confirmed ME/CFS cases and their health-related quality life (HRQoL). Methods This a cross-sectional with British Columbia Generations Project (BCGP) participants who self-reported having CFS population-based controls fatiguing illness. Participants completed Symptoms Assessment Questionnaire, RAND 36-item Health Survey, Phenotyping Questionnaire Short-form. These assessments enabled identification characterization “confirmed cases” ME/CFS. Those diagnoses did not meet diagnosis subcategorized as “non-ME/CFS cases.” Results We included 187 participants, 45.5% (n=85) 54.5% (n=102) controls; 34% (n=29) those fulfilled diagnostic criteria for population prevalence rates 1.1% 0.4% respectively. displayed significantly lower scores all eight SF-36 domains compared other groups. Mental component similar between non-ME/CFS main risk factor low HRQoL was fatigue severity (β = - 0.6, p<0.001 physical health; β -0.7, mental health). Conclusions majority do ME/CFS, suggesting that may be reliable indicator true diagnosis. indicators consistently controls, most domains. Having higher symptom perceived poorer health significant affecting factors HRQoL. Although self-report can used screening identify populations, we suggest studies should include appropriate medically clinical validity. Further large-scale simultaneous medical assessment are suggested further characterize validity parameters

Language: Английский

---

Shenling Baizhu San Alleviates Central Fatigue through SIRT1-PGC-1α-Mediated Mitochondrial Biogenesis

Journal of Ethnopharmacology, Journal Year: 2024, Volume and Issue: unknown, P. 119110 - 119110

Published: Nov. 1, 2024

Language: Английский

---

IgG Antibody Responses to Epstein-Barr Virus in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Their Effective Potential for Disease Diagnosis and Pathological Antigenic Mimicry

Medicina, Journal Year: 2024, Volume and Issue: 60(1), P. 161 - 161

Published: Jan. 15, 2024

Background and Objectives: The diagnosis pathology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) remain under debate. However, there is a growing body evidence for an autoimmune component in ME/CFS caused by the Epstein-Barr virus (EBV) other viral infections. Materials Methods: In this work, we analyzed large public dataset on IgG antibodies to 3054 EBV peptides understand whether these immune responses could help diagnose patients trigger pathological autoimmunity; used healthy controls (HCs) as comparator cohort. Subsequently, aimed at predicting disease status study participants using super learner algorithm targeting accuracy 85% when splitting data into train test datasets. Results: When compared all or subgroup those with non-infectious unknown triggers HC, not find antibody-based classifier that would meet desired dataset. identify 26-antibody distinguish infectious from HCs 100% 90% accuracies sets, respectively. We finally performed bioinformatic analysis associated 26 antibodies. found no correlation between importance metric selected maximal sequence homology human proteins each peptide recognized Conclusions: conclusion, against have effective potential subset patients. are less likely induce B-cell explain pathogenesis ME/CFS.

Language: Английский

---

Polarization in research: What is it, why is it problematic, and how can it be addressed?

Accountability in Research, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 23

Published: Dec. 15, 2024

Background: Polarized research has become a problem for the trustworthiness and applicability of scientific results. Accordingly, this paper addresses three key questions: 1) What is polarization in research? 2) Why such problematic? 3) How can be addressed?Methods: The first question addressed by describing how been characterized literature analysing an example before assessing existing definitions elaborating definition polarization. second answered challenges with found literature. third investigating different explanations relevant mechanisms behind research, as psychological, structural, epistemic ontological, evaluative, social-constructionist explanations. Moreover, several approaches from philosophy science are investigated.Results: Polarization opposing incommensurable positions that tend to stem differences basic values, used define, differentiate, bolster, demarcate between groups reinforcing their identity. it violates broad range norms science, hampers progress, represents large opportunity costs, undermines trust and, subsequently undercuts application results well future funding. There many potential measures reduce However, there no simple solutions, complex phenomenon deeply rooted human characteristics.Conclusion: ubiquitous challenge research. It crucial increase awareness polarization, clear study address problem. while ways actively easy solutions. More needed move what we do should do.

Language: Английский

---