Researchers have revealed how post-viral fatigue syndromes, including Long COVID, become life-changing illnesses and why patients suffer frequent relapses.
Usually arising from a viral infection, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is known to cause brain-centered symptoms of neuroinflammation, loss of homeostasis, brain fog, lack of restful sleep, and poor response to even minor stress.
Long-COVID has similar effects in humans and is also thought to be caused by neuroinflammation.
Lead author Emeritus Professor Warren Tate, from the University of Otago’s Department of Biochemistry, says how these debilitating brain effects develop is poorly understood.
In a study published in Frontiers in Neurology, he and colleagues from Otago, Victoria University of Wellington and the University of Technology Sydney developed a unifying model to explain how the brain-centric symptoms of these diseases are maintained by a brain-body connection.
They suggest that after an initial viral infection or stressful event, subsequent systemic pathology translocates to the brain via neurovascular pathways or across a dysfunctional blood-brain barrier. This leads to chronic neuroinflammation, which results in prolonged disease with recovery cycles in chronic relapse.
The model assumes that healing does not occur because a signal is constantly passing from the brain to the body, causing the patient to relapse.
Establishing this model is important not only for the “enormous research effort ahead,” but also to provide recognition for ME/CFS and Long COVID sufferers.
“These diseases are very closely related and it is clear that the biological basis of Long COVID is unequivocally linked to the original COVID infection – so there should no longer be debate and doubt about the fact that post-viral fatigue syndromes such as ME/CFS are biologically based and involve very disturbed physiology,” says Emeritus Professor Tate.
This work will enable healthcare professionals to develop the best evidence-based knowledge of these diseases and best management practices.
“Patients need appropriate confirmation of their biologically based disease and help to alleviate the distressing symptoms of these very difficult, life-altering syndromes that are difficult for patients to manage on their own.”
“This work highlights that there is a susceptible subset of people who develop such syndromes when exposed to severe stress, such as infection with COVID-19 or the Epstein Barr glandular fever virus, or in some people with vaccination that is interpreted as severe stress.
“What should be a transient inflammatory/immune response in the body to clear infection, develop immunity and manage physiological stress becomes chronic and so the disease persists.”
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