Soon after the corona pandemic broke out, the first reports of the so-called long Covid or post-Covid syndrome appeared. This is when symptoms are still present four weeks after a corona disease has subsided or if they come back. How long these can remain in place is still unclear. It is difficult to say how many Austrians are affected. There could be a high number of unreported cases.
The symptoms of those affected are varied. Especially those people who suffer from chronic exhaustion, which often make it impossible to lead a normal everyday life. Since the symptoms in many of those affected are similar or even the same as those of chronic fatigue syndrome, it has long been suspected that a corona infection can trigger ME/CFS (see info box for definition).
A research group from the Charité – Universitätsmedizin Berlin and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) is now showing in a well-controlled study that some of the Covid 19 sufferers actually have the full picture even after a mild course developed ME/CFS disease. The researchers also describe a second group of post-COVID sufferers with similar symptoms. Different laboratory values indicate possibly different development mechanisms of the two clinical pictures. The study results are in Journal of Nature Communications released.
“However, it is not trivial to prove this assumption scientifically,” explains Carmen Scheibenbogen, Acting Director of the Institute for Medical Immunology at the Charité Campus Virchow-Klinikum. “Through a very thorough diagnosis and a comprehensive comparison with ME/CFS sufferers who were ill after other infections, we have now been able to prove that ME/CFS can be triggered by Covid-19.”
So love the Study ab
For the study, experts examined 42 people who had contacted the Charité Fatigue Center at least six months after their Sars-CoV-2 infection because they were still suffering from severe exhaustion and limited resilience in their everyday lives. Most of them could only do light work for two to four hours a day, some were unable to work and could hardly support themselves. During the acute Sars-CoV-2 infection, only three of the 42 people affected went to the hospital, but did not need oxygen. 32 of them had not developed pneumonia, but generally felt severe symptoms such as fever, cough, muscle and body aches for one to two weeks.
Because the infection occurred in the first wave of the pandemic, none of the people included in the study had been previously vaccinated. For comparison, the researchers used 19 people with a similar age and gender profile and a comparable disease duration who had developed ME/CFS after another infection.
According to the specified criteria, almost half of the patients examined had the full picture of ME/CFS disease after their corona infections. The other half had comparable symptoms, but their discomfort after physical exertion was usually not as severe and only lasted for a few hours. In contrast, the worsening of symptoms in ME/CFS sufferers continued the next day. “So we can distinguish two groups of post-Covid affected people with greatly reduced resilience,” the team sums up.
In addition to recording the symptoms, the researchers determined various laboratory values and related them to the hand strength of the sufferers, which was reduced in most of them. “One of the things we found in people with less pronounced exercise intolerance was that they had less strength in their hands if they had an increased level of the immune messenger substance interleukin-8. In these cases, the reduced strength of the muscles may be due to an ongoing inflammatory reaction,” says Scheibenbogen. “In those affected with ME/CFS, on the other hand, hand strength correlated with the hormone NT-proBNP, which can be released by muscle cells when the oxygen supply is poor. This could indicate that reduced blood flow is responsible for their muscle weakness.”
Conclusion of the experts
According to preliminary observations, the distinction between the two groups could also be reflected in the course of the disease. “For many people who have ME/CFS-like symptoms but do not develop full-blown disease, symptoms appear to improve over time,” said Scheibenbogen. The new findings could contribute to the development of specific therapies for post-Covid syndrome and ME/CFS. “However, our data also provide further evidence that ME/CFS is not a psychosomatic disease, but a serious physical disease that can be detected using objective examination methods,” emphasizes Scheibenbogen. “Unfortunately, we can currently only treat ME/CFS symptomatically. That’s why I can only recommend young people to protect themselves from a Sars-CoV-2 infection by getting vaccinated and wearing FFP2 masks.”