ME/CFS as Part of the PCS Spectrum

Prof. Scheibenbogen explained that half of those affected by the post-COVID syndrome (PCS) met the diagnostic criteria for ME/CFS in an observational study by the Charité Fatigue Center. Scheibenbogen emphasized that current research on COVID-19 may be able to contribute to answering the question of what pathomechanisms underlie ME/CFS. A Charité study compared people with PCS without full ME/CFS and PCS with full ME/CFS and showed that people with full ME/CFS after COVID-19 showed significant differences compared to people with PCS without ME/CFS up to 20 months later. These patients had a tendency towards a chronic course of their condition and showed less improvement in symptoms, as well as more biomarkers indicative for chronic inflammation and a disturbed energy metabolism in the mitochondria.

Latest figures from German health insurance companies indicate that the number of people diagnosed with ME/CFS has at least doubled since the pandemic. In some PCS patients, acute inflammatory reaction after infection in combination with persistence of the virus in the body or reactivation of e.g. EBV transitions into a ME/CFS symptoms. This is then characterized by endothelial dysfunction, reduced blood flow in the small blood vessels (hypoperfusion) and increased autoantibodies.

In first clinical studies, the therapeutic approach of immunoadsorption (washing out autoantibodies from the blood) led to an improvement in the symptoms in some of the PCS patients with full ME/CFS.