Are Long COVID & Post-Viral Syndrome the same and where does CFS/ME fit in?

The current global pandemic has shone a major light on health. While coronavirus symptoms may fade and pass for the majority of people, some are still suffering with long-term effects which is referred to as Long COVID.  We are going to investigate if Long COVID is the same as Post-Viral Syndrome and where CFS fits in.

Long COVID

When most people get coronavirus, they make a full recovery.  However, according to the Office for National Statistics report in May 2021 an estimated 1.0 million people self reported Long Covid symptoms that persisted for more than four weeks from initial infection.  Out of this 1 million, two thirds had symptoms lasting more than 12 weeks and a fifth said their symptoms greatly limited their daily activities. 

The most common Long COVID symptoms include severe fatigue (547,000), followed by shortness of breath (405,000), muscle ache (313,000), and difficulty concentrating (285,000).

Other symptoms include: 

·        chest pain or tightness

·        difficulty sleeping (insomnia)

·        heart palpitations

·        dizziness

·        pins and needles

·        joint pain

·        depression and anxiety

·        tinnitus, earaches

·        feeling sick, diarrhoea, stomach aches, loss of appetite

·        a high temperature, cough, headaches, sore throat, changes to sense of smell or taste

·        rashes

·        Loss of smell and taste

Who is most at risk of developing Long COVID?

The Office of National Statistics say Long COVID prevalence has been greatest in people aged 35 to 69 years, females, and those who had five or more symptoms in the first week of becoming ill with Covid-19, those living in the most deprived areas, working in health or social care, and those with another activity-limiting health condition or disability especially asthma.  Prevalence was lowest in people of Asian ethnic background.

Post-Viral Syndrome (PVS)

Post-Viral Syndrome, also known as Post-Viral Fatigue Syndrome, refers to a prolonged sense of weakness and tiredness that persists after a person has fought off a viral infection. It can for example arise after common infections such as the flu.  So Covid-19 is likely capable of triggering post viral syndrome which may be diagnosed as Long COVID.

The symptoms of post-viral syndrome may vary from person to person, but most people describe feeling extreme fatigue and generally unwell.  This feeling persists no matter how many hours of sleep the person gets or how well they take care of themselves.  These post-viral symptoms may be experienced for weeks or even months after fighting off the initial infection. 

Is there a link to Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME)?

Many doctors will treat Post-Viral Syndrome in the same way as they treat Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME), as they have similar presentations. 

CFS is a complex, long-term illness that can affect the whole body, causing pain and extreme fatigue.  Its cause is unknown but it has been seen to be triggered by viral and bacterial infections, such as glandular fever and pneumonia. More than 1 in every 10 people with glandular fever will experience prolonged fatigue, which lasts for six months or more after the initial infection. Issues with the immune system, hormone imbalance, mental health problems, such as stress and emotional trauma are all implicated in CFS. 

Many CFS symptoms mimic other conditions, making it hard to diagnose. The common symptoms can vary among individuals, but there are three core presentations:

1.     Reduced ability to do activities that were previously possible.

A person with CFS will experience fatigue that affects their ability to carry out daily tasks.  For a diagnosis of CFS syndrome, the fatigue must decrease in activity levels must last 6 months or longer and does not improve with rest.

2.     Post-exertional malaise

A person with post-exertional malaise will experience a crash after physical or mental exertion such as difficulty thinking. 

3.     Sleep disorders

The person may feel exhausted but be unable to sleep or feel refreshed after sleeping.

Mitochondrial support is always a consideration with CFS Syndrome patients and those with intracellular infections. These pathogens use our cellular organelles, ATP pool and micronutrients in order to facilitate their own replication and survival which contributes to poor cellular functioning and fatigue. Therefore, we can see that both Long COVID and Post-Viral Syndrome may be linked to CFS.

For a diagnosis you also have to have one or more of these presentations:

·        muscle and/or joint pain that is multi-site and without evidence of inflammation

·        headaches

·        painful lymph nodes without pathological enlargement

·        sore throat

·        cognitive dysfunction, such as difficulty thinking, inability to concentrate, impairment of short-term memory, and difficulties with word-finding, planning/organising thoughts and information processing

·        physical or mental exertion makes symptoms worse

·        general malaise or 'flu-like' symptoms

·        dizziness and/or nausea

·        palpitations in the absence of identified cardiac pathology.

So are they the same?

We can see that the symptoms in Long COVID, Post-Viral Syndrome and CFS are very similar and are often triggered by a virus. However, there are still so many unknowns about its aetiology, and presentations are varied and complex.

We know that, while COVID-19 has killed more men than women, Long COVID seems to be predominantly female. Physicians at a Paris Hospital recently reported that women outnumbered men 4:1 – the same rate by which women outnumber men in CFS.

We understand that diagnosed Long COVID may be a post viral syndrome and anecdotally, there’s no question that there are a considerable number of individuals who have a Post Viral Syndrome that really can incapacitate them for weeks and weeks, following so-called recovery and clearing of the virus, highly suggestive of CFS/ME.

However, although Long COVID and Post-Viral Syndrome have many similarities, due to their differences in terms of proper symptom diagnosis, we cannot say that they are the same, and although CFS is similar further research is needed to understand the specific differences.

As a functionally trained nutritional therapist the extra research is being undertaken for Long COVID patients is vital but it also allows the conversation long suffering CFS/ME patients to remain open.  Due to the similarities research may enhance options for them. 

Here at Bespoke Nutritional Therapy, we can provide a Bespoke 1:1 nutrition and health package - a minimum of 3 consultations over 3 months.  We will evaluate your full health history so we get to the root cause of your health concern and put together a bespoke plan to address your specific needs and goals. You will leave with a manageable and effective nutrition and lifestyle programme personal to your needs. We are here to help you feel better!