Post Viral Fatigue Syndrome

Myalgia and joint pain, cognitive deficits, unrefreshing sleep, autonomic dysfunction, neuropsychiatric symptoms, and incapacitating post-exertional exhaustion are all hallmarks of post-viral fatigue syndrome (PVFS), a broad category of complicated neuroimmune illnesses with unclear aetiology. It encompasses fibromyalgia (FM), myalgia encephalomyelitis, sometimes referred to as chronic fatigue syndrome (ME/CFS), and, more recently, the COVID-19 illness (long COVID). The hallmark symptom of PVFS is prolonged post-exertional fatigue, which gets worse with little physical or mental effort. Other symptoms include joint and myalgia pain, cognitive impairments, unrefreshing sleep, dysautonomia, and neuropsychiatric symptoms like apathy, anxiety/depression, and emotional lability, which usually follow recurrent viral infections. Despite not being a widely recognized ailment, PVFS has recently been linked more and more to the post-COVID-19 syndrome. The CDC currently projects that more than 150 million individuals globally will be impacted by a significant rise in ME/CFS prevalence following COVID-19 by 2050. Disease onset is multifactorial (i.e., a mix of environmental and immunogenetic elements); it can happen abruptly or evolve gradually over time; and it is usually linked to triggering events, which can include physical and psychological trauma in addition to viral infections. PVFS is often triggered by common viral infections such as the Epstein–Barr virus (EBV), human herpesvirus (HHVs), cytomegalovirus (CMV), SARS- CoV-2 (COVID-19), amongst others. Overwhelming exhaustion and extensive physical pain that is not relieved by rest and cannot be attributed to any underlying medical illness are hallmarks of ME/CFS, FM, and long-term COVID, devastating multisystem conditions that affect most body systems. People may have a variety of symptoms in addition to the "prime" ones of exhaustion and chronic pain, including post-exertional malaise, restless sleep, cognitive deficits known as "brain fog" orthostatic intolerance, and gastrointestinal issues. Because of their vital function in cellular energy metabolism, mitochondria—the cellular powerhouses that produce energy—have recently attracted attention in PVFS research. Low-grade systemic inflammation in ME/CFS, FM, and long-term COVID patients has been linked to mitochondrial dysfunction, which includes oxidative stress, redox imbalance, altered mitochondrial membrane potential/permeability, disturbed calcium homeostasis, and impaired ATP production, according to the growing body of research. Several overlapping symptoms, including cognitive impairments, sleep disruptions, brain fog, concentration/memory deficits, and muscle soreness, are often present in addition to exhaustion in these disorders. At least some of these symptoms can be linked to mitochondrial dysfunction, which can affect how energy is metabolized in the brain. In both adults and children/adolescents, fibromyalgia patients have decreased tissue levels of CoQ10 (usually 40–50% of the normal amount), along with elevated levels of oxidative stress, inflammation, and mitochondrial dysfunction. Recent research indicates that, considering the critical role that CoQ10 plays in normal mitochondrial activity, CoQ10 supplementation may play a part in the treatment of the illnesses. Through its capacity to restore electron flow in the mitochondrial respiratory chain (MRC), which will increase ATP synthesis by oxidative phosphorylation, CoQ10 supplementation may improve mitochondrial dysfunction and reduce tiredness linked to PVFS. Additional randomized controlled trials are needed to demonstrate the effectiveness of CoQ10 supplementation in individuals with ME/CFS and extended COVID. Randomized controlled clinical trials have reported considerable symptomatic advantages in the treatment of these illnesses, especially for FM. Notably, clinical trials using CoQ10 supplements in individuals with PVFS and a variety of other chronic conditions have not revealed any significant negative effects. Low-grade systemic inflammation in ME/CFS, FM, and long-term COVID has been linked to mitochondrial dysfunction, according to the growing body of research. Emerging evidence, including RCTs, supports the efficacy of coenzyme Q10 supplementation on chronic tiredness and pain symptoms as a unique therapeutic approach for the treatment of PVFS. If you want to speak to a Professional, please visit the website & book an appointment at Brain Health Clinic as Neuropsychiatry Online Clinic. Please visit www.thebrainhealth.co.uk or write to admin@thebrainhealth.co.uk 0207 183 1229 0756 338 9300 References: 1) Mantle D, Hargreaves IP, Domingo JC, Castro-Marrero J. Mitochondrial Dysfunction and Coenzyme Q10 Supplementation in Post-Viral Fatigue Syndrome: An Overview. Int J Mol Sci. 2024 Jan 1;25(1):574. doi: 10.3390/ijms25010574. PMID: 38203745; PMCID: PMC10779395. 2) Komaroff A.L., Lipkin W.I. ME/CFS and Long COVID share similar symptoms and biological abnormalities: Road map to the literature. Front. Med. 2023;10:1187163. doi: 10.3389/fmed.2023.1187163 3) Komaroff A.L. Chronic “post-infectious” fatigue syndrome. Trans. Am. Acad. Insur. Med. 1993;76:82–95 4) Poenaru S., Abdallah S.J., Corrales-Medina V., Cowan J. COVID-19 and post-infectious myalgic encephalomyelitis/chronic fatigue syndrome: A narrative review. Ther. Adv. Infect. Dis. 2021;8:20499361211009385. doi:10.1177/20499361211009385. 5) Hamilton W.T., Gallagher A.M., Thomas J.M., White P.D. The prognosis of different fatigue diagnostic labels: A longitudinal survey. Fam. Pract. 2005;22:383–388. doi: 10.1093/fampra/cmi021 6) Mahroum N., Shoenfeld Y. 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Dr Mohan Babu Ratnaiah, MBBS, MRCPsych, PhD

6/21/20251 min read

Several young individuals are sitting in a classroom or conference setting. One person is standing and smiling, while others are seated, some wearing masks. The atmosphere appears to be informal and engaging.
Several young individuals are sitting in a classroom or conference setting. One person is standing and smiling, while others are seated, some wearing masks. The atmosphere appears to be informal and engaging.

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