Research into the long-term consequences of the COVID-19 pandemic

In an open letter published on ME Awareness Day 2020, Evelien Van Den Brink asks the European parliament to make sufficient funds available for scientific research into the long-term consequences of COVID-19.

COVID-19 has an enormous impact on European countries. The great number of people who have become infected, the severity of the infection, and the number of deaths are major causes for concern. In the light of this pandemic, I would like to ask the European Parliament to pay attention not just to the acute effects of the disease, but also to the long-term consequences.

The previous 2009 pandemic of the H1N1 influenza virus was associated with a more than two-fold increased risk of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). (1) ME/CFS is a debilitating chronic illness that causes extreme exhaustion, cognitive dysfunction, chronic pain, and a range of other symptoms. Many ME/CFS patients remain ill for decades and an estimated 25 percent of ME/CFS patients are house- or bedbound at some point in their illness. (2)

ME/CFS is often triggered by common viruses, most notably the Epstein Barr-Virus. (3) It is a cause of concern that the SARS-CoV-2 pandemic will lead to an increased risk of ME/CFS or related post-viral fatigue syndromes. Indeed, an ME/CFS-like illness following the 2003 SARS Coronavirus outbreak has been reported in the scientific literature (4,5) and there are preliminary reports of patients who develop long-lasting and debilitating symptoms after COVID-19. (6,7) Whether this condition is similar or related to ME/CFS is uncertain and remains to be determined.

The chronic sequelae of COVID-19 should be thoroughly investigated so that patients with lingering complaints can be helped to regain their health and productivity. Although COVID-19 has caused enormous health- and economic crises, it also provides an exceptional scientific opportunity to conduct prospective and longitudinal research. Some studies have already been initiated. (8,9) This could provide long-awaited answers to the question of why some persons fail to recover from certain viral infections.

I, therefore, call upon the Members of the European Parliament to request the European Commission to make sufficient funds available for scientific research into the long-term consequences of COVID-19. High-quality research could give doctors the knowledge and tools to prevent long-term harm to the health of infected European citizens.

Thank you very much for your attention.

References

1. Magnus P, Gunnes N, Tveito K, Bakken IJ, Ghaderi S, Stoltenberg C, et al. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine. Vaccine. 2015 Nov 17;33(46):6173–7.

2. Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Board on the Health of Select Populations, Institute of Medicine. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness.  Washington (DC): National Academies Press (US); 2015. Available from: http://www.ncbi.nlm.nih.gov/books/NBK274235/

3. Hickie I, Davenport T, Wakefield D, Vollmer-Conna U, Cameron B, Vernon SD, et al. Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study. BMJ. 2006 Sep 16;333(7568):575.

4. Moldofsky H, Patcai J. Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study. BMC Neurol. 2011 Mar 24;11:37.

5. Lam MH-B, Wing Y-K, Yu MW-M, Leung C-M, Ma RCW, Kong APS, et al. Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up. Arch Intern Med. 2009 Dec 14;169(22):2142–7       

6. Newey S. Coronavirus could cause secondary illnesses including chronic fatigue syndrome, experts warn. The Telegraph. 2020 May 2; Available from: https://www.telegraph.co.uk/global-health/science-and-disease/coronavirus-could-cause-secondary-illnesses-including-chronic/

7. Davis N. Lingering and painful: the long and unclear road to coronavirus recovery. The Guardian. 2020 May 1; Available from: https://amp.theguardian.com/world/2020/may/01/lingering-and-painful-long-and-unclear-road-to-coronavirus-recovery-long-lasting-symptoms?__twitter_impression=true

8. Open Medicine Foundation (OMF). Study of the possible conversion of COVID-19 patients to ME / CFS. April 26, 2020. Available from: https://www.omf.ngo/2020/04/26/tracking-covid-19-patients/

9. Charité Berlin. Registerstudie zum Verlauf von SARS-CoV-2-Infektionen bei ME/CFS-Erkrankten. March 17, 2020. Available from: https://www.mecfs.de/informationen-zu-covid-19-corona/

News Articles

Wilson C. Could the coronavirus trigger post-viral fatigue syndromes? New Scientist. April 15, 2020. Available from: https://www.newscientist.com/article/mg24632783-400-could-the-coronavirus-trigger-post-viral-fatigue-syndromes/

Harmsen T. Corona kann krankhaft-chronisches Erschöpfungssyndrom auslösen. Berliner Zeitung. May 9, 2020. Available from: https://www.berliner-zeitung.de/gesundheit-oekologie/corona-koennte-schwere-chronische-erschoepfung-ausloesen-li.82909

Horowitz J. Surviving Covid-19 May Not Feel Like Recovery for Some. New York Times. May 10, 2020. Available from: https://www.nytimes.com/2020/05/10/world/europe/coronavirus-italy-recovery.html?action=click&module=Top%20Stories&pgtype=Homepage