Topic

Long COVID Overlap

Domain: Immunology

PEM-relevant research

4 studies in the atlas

ME/CFS-like illness following SARS-CoV-2 infection and parallels with post-acute sequelae.

What We Know

A substantial proportion of Long COVID patients meet ME/CFS diagnostic criteria, including PEM. Shared biological features include immune dysregulation, autonomic dysfunction, and metabolic disturbances. Long COVID has accelerated ME/CFS research funding.

What We Think

Comparative omics studies between Long COVID-ME/CFS and classical ME/CFS are underway to identify shared and divergent mechanisms.

What We Don't Know

It is unknown whether Long COVID ME/CFS is pathophysiologically identical to pre-pandemic ME/CFS. Viral persistence, autoimmunity, and microbiome disruption are competing explanatory models.

Studies in this Topic

E0 ConsensusPEM ?Moderate confidenceReviewed

ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature

Anthony L. Komaroff, W. Ian Lipkin·Frontiers in Medicine·2023

Harvard and Columbia researchers conducted a comprehensive review of biological abnormalities in ME/CFS and Long COVID. They found striking overlaps in immune dysregulation, autonomic dysfunction, metabolic disruption, and neurological features. The paper maps the literature to guide researchers working across both conditions.

Long COVID OverlapImmune Dysregulation

E0 ConsensusPEM ?Higher confidenceReviewed

Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Grach, Stephanie L, Seltzer, Jaime, Chon, Tony Y et al.·Mayo Clinic proceedings·2023

This review explains how doctors can diagnose and manage ME/CFS, a serious illness that causes extreme tiredness and other symptoms, often starting after an infection. The authors note that ME/CFS shares many similarities with long COVID, the condition some people experience after having COVID-19. They provide practical guidance to help healthcare providers recognize and treat this condition.

Long COVID OverlapPost-Exertional Malaise

E2 ModeratePEM ✓Moderate confidenceMachine draft

ME/CFS and Post-Exertional Malaise among Patients with Long COVID.

Jason, Leonard A, Dorri, Joseph A·Neurology international·2022

Researchers studied 465 people with long-term COVID symptoms to see how many also had ME/CFS (a serious condition causing extreme fatigue and worsening after activity). They found that about 6 in 10 people with long COVID met the medical criteria for ME/CFS. Interestingly, some people thought they had ME/CFS when they didn't, while others had ME/CFS without realizing it—showing that self-diagnosis alone isn't reliable.

Long COVID OverlapPost-Exertional Malaise

E3 PreliminaryPEM ?Moderate confidenceReviewed

Mitochondrial Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Syed, Abu Mohammad, Karius, Alexander K, Ma, Jin et al.·Physiology (Bethesda, Md.)·2025

This review examines how mitochondria—the parts of cells that produce energy—may not be working properly in ME/CFS patients. The authors suggest that problems with energy production in cells could explain why people with ME/CFS feel severely exhausted after physical activity. They also note that similar energy problems appear in long COVID, which suggests both conditions may share a common underlying cause.

Long COVID OverlapPost-Exertional Malaise