VMany people still do not feel healthy months after a Covid-19 infection. Long-Covid sometimes also affects those who were only mildly ill. Some suffer from chronic exhaustion – they can no longer cope with their everyday life, suffer from pain and lack of concentration. A recent study by a team from the Berlin Charité led by the immunologist Carmen Scheibenbogen now provides new evidence: A Covid 19 infection is related to pathological exhaustion. “The study shows in a very thoroughly examined group of patients that the clinical picture ME/CFS belongs to the spectrum of post-Covid syndrome,” says Scheibenbogen, Deputy Director of the Institute for
Medical Immunology. There are also few other study papers that describe this. “But we had the patients carefully examined by a wide variety of doctors, such as neurologists or rheumatologists. Nothing else can explain the patients’ symptoms.”
Chronic Fatigue Syndrome is a complex neurological condition known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, or ME/CFS for short. How exactly this disease develops is still unclear. It often occurs after viral diseases such as glandular fever, which is caused by the Epstein-Barr virus. Carmen Scheibenbogen is an expert in ME/CFS, and for many years the outpatient clinic for immunodeficiencies she managed at the Berlin University Hospital was the only one in Germany.
Those affected, in Germany there were an estimated 250,000 people before the pandemic, have enormous difficulties in coping with their everyday lives, around seventy percent are unable to work. After slight exertion, the symptoms become more severe, and in many cases there is a “crash” that lasts for days. Other symptoms include cardiovascular problems, with dizziness, tachycardia and fluctuating blood pressure. The muscles are weak or painful, the patients have memory problems. “It is often said that many symptoms of the post-Covid syndrome are psychosomatic,” says Scheibenbogen. “But in our study we showed that the patients really do have physical limitations.”
There is a lot to be said for an autoimmune disease
In the journal “Nature Communications” Scheibenbogen and her team have now published data from 42 people affected. In a prospective study, the researchers compared 29 patients and 13 patients (mean age 36.5 years) six months after contracting Covid-19 with matched subjects who had ME/CFS unrelated to Covid-19. “When the patients stand up, the blood pressure often drops and the heartbeat gets much too fast,” explains Scheibenbogen. While this phenomenon also affects healthy people, it is much more pronounced in ME/CFS patients. Muscle strength can be studied using an instrument that measures hand strength. This was significantly reduced in the post-Covid patients. The doctors also checked the blood values. “We have seen that the low muscle strength correlates with values that are associated with reduced blood flow.” For example, that for the NT-pro-BNP. This is a peptide that is produced by heart muscle cells, but also by muscle cells – and as a biomarker provides an indication of a disrupted oxygen supply. Although the concentration for many patients was in the high normal range, the higher the value, the weaker the muscle strength. “There has to be a connection.” This weakness was also associated with increased inflammation values, such as the concentration of the C-reactive protein or interleukin 8. In some patients, the reduced blood flow seems to play a greater role, in others the smoldering inflammation.