Young people at high risk of chronic fatigue post-COVID-19

A recent review of three case studies by Johns Hopkins University researchers provides first evidence that one serious post-COVID problem may be myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — the complex, multi-system disorder

Young adults who survived COVID-19, even with mild infections, are at increased risk of a serious post-COVID or “long haul” problem — chronic fatigue syndrome, say researchers.

A recent review of three case studies by Johns Hopkins University researchers provides the first evidence that one serious post-COVID problem may be myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — the complex, multi-system disorder previously known as chronic fatigue syndrome.

“In the three patients studied — all of whom had confirmed or highly probable COVID-19 infections early in the pandemic — we observed ME/CFS-like symptoms within the first two weeks of illness,” said Peter Rowe, Director, Johns Hopkins Children’s Center and Professor – Paediatrics, Johns Hopkins University School of Medicine.

“At six months following their illness, all three still met the criteria for being diagnosed with ME/CFS,” Rowe added.

The three patients evaluated in the recent study, published in the journal Frontiers in Medicine, were a 19-year-old man and two women, aged 22 and 30, whose COVID-19 symptoms began between April and June 2020.

Symptoms of orthostatic intolerance — a group of clinical conditions that include fatigue, light-headedness and difficulty concentrating, and are linked with greater than 90 per cent of the people with ME/CFS — were prominent in all three from the outset of their COVID-19 illness.

A six-month post-COVID symptom onset examination, including evaluations of movement, neurological function and continued orthostatic intolerance, was conducted on each of the patients to determine if ME/CFS could be diagnosed. All three easily met the criteria.

Interestingly, all three patients had relatively mild COVID-19 respiratory symptoms and none required hospitalisation, yet it appears to have translated into the more serious secondary problem of ME/CFS for them all, Rowe said.

Further research is needed to define the biological mechanism by which ME/CFS arises from COVID-19, and then use that insight to develop treatment strategies that can return patients with post-COVID ME/CFS back to their previous quality of life, the team said.