A Comprehensive Examination of Severely Ill ME/CFS Patients

Chia-Jung Chang; Li-Yuan Hung; Andreas M Kogelnik; David Kaufman; Raeka S Aiyar; Angela M Chu; Julie Wilhelmy; Peng Li; Linda Tannenbaum; Wenzhong Xiao; Ronald W Davis

doi:10.3390/healthcare9101290

A Comprehensive Examination of Severely Ill ME/CFS Patients

Healthcare (Basel). 2021 Sep 29;9(10):1290. doi: 10.3390/healthcare9101290.

Authors

Chia-Jung Chang^{1

2

3}, Li-Yuan Hung⁴, Andreas M Kogelnik⁵, David Kaufman¹, Raeka S Aiyar^{1

2

3}, Angela M Chu^{1

2

3}, Julie Wilhelmy^{1

2

3}, Peng Li⁴, Linda Tannenbaum⁶, Wenzhong Xiao^{1

2

3

4}, Ronald W Davis^{1

2

3

7}

Affiliations

¹ ME/CFS Collaborative Research Center at Stanford, Stanford University School of Medicine, Palo Alto, CA 94305, USA.
² Stanford Genome Technology Center, Stanford University School of Medicine, Palo Alto, CA 94304, USA.
³ Department of Biochemistry, Stanford University School of Medicine, Palo Alto, CA 94305, USA.
⁴ ME/CFS Collaborative Research Center at Harvard, Massachusetts General Hospital, Boston, MA 02114, USA.
⁵ Basis Diagnostics, Newark, CA 94560, USA.
⁶ Open Medicine Foundation, Agoura Hills, CA 91301, USA.
⁷ Department of Genetics, Stanford University School of Medicine, Palo Alto, CA 94305, USA.

Abstract

One in four myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients are estimated to be severely affected by the disease, and these house-bound or bedbound patients are currently understudied. Here, we report a comprehensive examination of the symptoms and clinical laboratory tests of a cohort of severely ill patients and healthy controls. The greatly reduced quality of life of the patients was negatively correlated with clinical depression. The most troublesome symptoms included fatigue (85%), pain (65%), cognitive impairment (50%), orthostatic intolerance (45%), sleep disturbance (35%), post-exertional malaise (30%), and neurosensory disturbance (30%). Sleep profiles and cognitive tests revealed distinctive impairments. Lower morning cortisol level and alterations in its diurnal rhythm were observed in the patients, and antibody and antigen measurements showed no evidence for acute infections by common viral or bacterial pathogens. These results highlight the urgent need of developing molecular diagnostic tests for ME/CFS. In addition, there was a striking similarity in symptoms between long COVID and ME/CFS, suggesting that studies on the mechanism and treatment of ME/CFS may help prevent and treat long COVID and vice versa.

Keywords: antibody and antigen; clinical symptoms; cognitive tests; laboratory tests; long COVID; post-acute sequelae SARS-CoV-2 infection (PASC); quality of life; severe ME/CFS; sleep; viral infection.