Oxidative stress makes long-haul COVID-19 like chronic fatigue

Aug. 26, 2021

A team of researchers, including two from Johns Hopkins Medicine, have published a review article highlighting similarities between certain lingering symptoms following COVID-19 illness — a condition called “long COVID” — and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a debilitating, complex disorder previously known as chronic fatigue syndrome.

The researchers say the symptoms shared by the two conditions may involve a biological response that goes haywire when the body encounters certain infections or other environmental hazards.

“The body’s response to infection and injury is complex and covers all body systems,” says lead author Bindu Paul, PhD, Assistant Professor of Pharmacology and Molecular Sciences at the Johns Hopkins University School of Medicine. “When that response is in disarray — even just one aspect of it — it can cause feelings of being tired, brain fog, pain and other symptoms.”

In their review, published in the Proceedings of the National Academy of Sciences, Paul and her co-authors highlight the evidence seen in both acute COVID and ME/CFS of various underlying biological disorders. In particular, the researchers suggest a central role for the way cells behave when too many oxygen molecules pile up in a cell — a process called oxidative stress or redox imbalance. The team describes how redox imbalance may be connected to the inflammation and disorders of metabolism that are found in the two diseases.

ME/CFS is a complex condition affecting 1 million to 2.5 million people in the United States. It is characterized by a cluster of symptoms, including severe and debilitating fatigue, disrupted and unrefreshing sleep, difficulty thinking (commonly called “brain fog”), abnormalities of the autonomic nervous system and post-exertional malaise — a flare-up of multiple symptoms following physical or cognitive exertion.

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