A Comprehensive Examination of Severely Ill ME/CFS Patients.

Chia-Jung Chang,Linda Tannenbaum,David Kaufman,Angela M Chu,Peng Li,Andreas M Kogelnik,Julie Wilhelmy,Raeka S Aiyar,Ronald W Davis,Wenzhong Xiao,Li-Yuan Hung

doi:10.3390/healthcare9101290

Abstract

One in four myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients are estimated to be severely affected by the disease, and these house-bound or bedbound patients are currently understudied. Here, we report a comprehensive examination of the symptoms and clinical laboratory tests of a cohort of severely ill patients and healthy controls. The greatly reduced quality of life of the patients was negatively correlated with clinical depression. The most troublesome symptoms included fatigue (85%), pain (65%), cognitive impairment (50%), orthostatic intolerance (45%), sleep disturbance (35%), post-exertional malaise (30%), and neurosensory disturbance (30%). Sleep profiles and cognitive tests revealed distinctive impairments. Lower morning cortisol level and alterations in its diurnal rhythm were observed in the patients, and antibody and antigen measurements showed no evidence for acute infections by common viral or bacterial pathogens. These results highlight the urgent need of developing molecular diagnostic tests for ME/CFS. In addition, there was a striking similarity in symptoms between long COVID and ME/CFS, suggesting that studies on the mechanism and treatment of ME/CFS may help prevent and treat long COVID and vice versa.

Highlights

Introduction published maps and institutional affilMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic complex disease characterized by unrelenting fatigue, post-exertional malaise, sleep problems, cognitive impairment, and orthostatic intolerance [1]
To systematically evaluate whether clinically recognized biomarkers show the difference between severe ME/CFS and healthy controls, an extensive set of clinical laboratory tests were performed on the blood, urine, and saliva samples in this study
The most significant difference between severe ME/CFS and the controls came from the 4-point salivary cortisol levels, which were tested upon wakening, at noon, afternoon, and night

Summary

Introduction

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic complex disease characterized by unrelenting fatigue, post-exertional malaise, sleep problems, cognitive impairment, and orthostatic intolerance [1]. This debilitating illness is known to affect between 836,000 and 2.5 million people in the United States alone [1,2,3], and the majority of the patients remain undiagnosed [1,4]. Patients often report symptoms started with viral infection [1,2,5]. Despite the severity of the clinical symptoms, the etiology and pathophysiology of the disease remain unclear. There is neither a validated biomarker for diagnosis nor an FDA-approved drug available for treatment

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Results

Conclusion