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Clinical guidance for ME/CFS may also help Long COVID patients

Updated clinical guidance for myalgic encephalomyelitis/ chronic fatigue syndrome (ME​/​CFS), produced by the US ME​/​CFS Clinician Coalition, may also help patients who remain ill with Long COVID after even mild cases of COVID-19. An article about the update has been published in Mayo Clinic Proceedings:

Read it here

Recent research suggests 10 percent or more of adults with acute COVID-19 may go on to develop ME​/​CFS. Patients with ME​/​CFS have long struggled to access clinical care as a result of a lack of accurate clinical guidance and provider knowledge. The significant influx of new ME​/​CFS cases has created an urgent need for clinicians everywhere to learn about this disease.

The updated clinical guidance from the US ME​/​CFS Clinician Coalition focuses on adults and includes:

  • New diagnostic criteria requiring post-exertional malaise and other key features to improve diagnostic accuracy
  • Efficient use of interview questions, physical examination findings, and diagnostic testing
  • Alternative diagnoses and co-existing conditions to consider
  • Pharmacological and nonpharmacological treatments
  • A discussion of why previously-recommended treatments — cognitive behavioral therapy and graded exercise therapy — can be harmful and are no longer recommended

There are no FDA-approved treatments for ME​/​CFS. However, authors of the article state that, in their experience, improvement is possible with appropriate care, and  provide their consensus recommendations with a variety of available treatments.

Author Dr. Lucinda Bateman notes:

“There are many steps clinicians can take now to improve the health, function, and quality of life of people with ME​/​CFS, including those newly ill with ME​/​CFS following COVID-19. This guidance may also help Long COVID patients, even if they do not fully meet criteria for ME​/​CFS.”

Watch the accompanying video by Dr. Lucinda Bateman:

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Microvesicles and viral sequencing
Microvesicles are a type of extracellular vesicle that is released from the cell membrane. Vesicles are small, fluid-filled sacs or vacuoles within the body. Sequencing is a technique used to determine the exact sequence of bases (A, C, G, and T) in a DNA (or viral) molecule.
NMR Metabolomics
NMR (Nuclear Magnetic Resonance) is an instrument/tool used to perform metabolic studies, metabolic profiling, and metabolomics in biofluids and tissues for more than 40 years using magnetic fields. There is a very close connection between metabolic measurements and NMR. This connection has flourished because of NMR’s many unique strengths for characterizing complex mixtures’ chemical composition.
Proteomics
The large-scale study of proteins, which are large, complex molecules that are required for structure, function, and regulation of the human body's tissues and organs.
Immune cell profiling
The immune system has many important regulatory roles in disease development and progression. Given the emergence of effective immune therapies, reliable predictors of response are needed. Immune cell profiling determines response by evaluating immune cell populations from treated and untreated samples. For our purposes, we will evaluate the white blood cell response to the viral infection using a process called “Cytof.”
Leukocyte Genomics
A leukocyte is a colorless cell circulating in the blood and body fluids and is involved in counteracting foreign substances and disease. A genome is all genetic material of an organism. Genomics is a biology field focusing on the structure, function, evolution, mapping, and editing of genomes. Therefore, leukocyte genomics is the study of all genetic material of leukocytes.
Metabolomics
Metabolomics is a way to study metabolism – that is, through measuring amounts of the metabolites (small molecules) produced by our bodies as we convert food into energy and other molecules that our cells need to survive. Metabolomics technology is ‘large-scale,’ meaning that several thousand metabolites can be measured from a single sample of e.g., blood or urine.
Micro RNA
Cells use Micro RNA to control whether a particular gene is making too much, too little or the normal amount of its protein at a particular time.
Autoantibodies
Antibodies that react with self-molecules and that occur in healthy individuals and are referred to as natural antibodies or autoantibodies.
Extracellular DNA for viral reactivation and Mitochondrial DNA
exDNA (extracellular DNA), exDNA is often secreted actively and is used to perform several tasks, thereby offering an attractive target or tool for biotechnological, medical, environmental, and general microbiological applications. Viruses are intracellular parasites that rely to a significant extent on the host cell for replication. Viral reactivation occurs when an active replication of the viral genome results in a lytic (degradation of the cell) infection characterized by the release of new progeny (descendant) virus particles.