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Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic, complex, neuroimmune disease that profoundly limits the health and productivity of patients and is often triggered by an infection. The main symptoms are extreme exhaustion (exacerbated by activity), cognitive dysfunction and unrefreshing sleep. Other symptoms may vary.
Long Covid describes a collection of lingering symptoms devastating the lives of many infected by COVID-19. Long Covid affects an estimated 10-30% of people infected with COVID-19, including those who were asymptomatic. The most frequent prolonged symptoms are persistent fatigue, brain fog, and depleted energy after even a minimal effort.
Because post-infection diseases are not yet fully understood, there is no cure for ME/CFS or Long Covid, nor are there any FDA-approved drugs or treatments. However, there are interventions and symptom-reduction strategies that you can use to significantly improve patients’ quality of life. Providing compassionate and effective care for patients with ME/CFS and Long Covid can be challenging, like many other multisystemic chronic conditions. Patients and their providers must be partners with open lines of communication in order to effectively manage this illness. Below you will find education based on current research:
Center of Disease Control: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
The CDC has created a toolkit for healthcare providers to assist with assessing and managing symptoms, and providing other supportive strategies:
ME Association Booklet: Diagnosis of ME/CFS – Importance of Early & Accurate Diagnosis
The US ME/CFS Clinician Coalition produced updated clinical guidance for ME/CFS, which include:
The British Association of Clinicians in ME/CFS also has excellent symptom management resources available.
In 2015, the National Academy of Medicine (NAM) — formerly called the Institute of Medicine (IOM) — published a report summarizing the evidence base and redefining the diagnostic criteria. Key findings of the report included:
The CDC has published interim guidance for “Post-COVID Conditions,” an umbrella term for the wide range of symptoms experienced by some patients that are present four or more weeks after SARS-CoV-2 infection.
A new clinical challenge: supporting patients coping with the long-term effects of COVID-19, created by National Institutes of Health (NIH) Community Advisory members.
BMJ Long Covid Guide to Primary Care
Overview of the Impacts of Long COVID on Behavioral Health (SAMHSA)
AAPM&R’s Multidisciplinary PASC Collaborative published a series of consensus based guidance articles:
Assessment and treatment of fatigue in postacute sequelae of SARS-CoV-2 infection (PASC) patients
Cognitive symptoms in patients with post-acute sequelae of SARS-CoV-2 infection (PASC)
Covid-19 Longhauler Advocacy Project (C-19LAP): A Comprehensive Guide for COVID-19 Longhaulers and Physicians
C-19LAP created this “Master Document” as a guide to help Longhaulers and their physicians work as a team in an attempt to get the patient back to good health and regain quality of life.
Journal of Orthopaedic & Sports Physical Therapy: Humility and Acceptance: Working Within Our Limits With Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Resources and Guidance for Coding
Medscape + CDC Online Courses:
Bateman Horne Center CME and CNE Offerings
Michigan State Medical Society:
Workwell Foundation + MedBridge courses for physical, occupational and speech therapists as well as nurses and other health care providers:
Long COVID and Fatiguing Illness Recovery Program (Family Health Centers of San Diego, the ECHO Institute, University of Washington and University of Colorado
Doctors with ME: Doctors with M.E. is the global professional association for medical practitioners and scientists in the field, bringing together leading experts, regional associations and the quarter of a million healthcare professionals with ME. Check out their resources, “Putting it into Practice: What NICE ME/CFS means for GPs,” ME/CFS: What Psychiatrists Need to Know, & ME/CFS: Top Tips Handout for Doctors
ME/CFS: Causes, Clinical Features and Diagnosis (Medicina)
Pacing and Management Guide for ME/CFS and Long COVID (#MEAction, Patient-Led Research Collaborative)
Chronic Fatigue Syndrome: What Nurses Need to Know, Marianne Bush, BS, RN
Health Care Responsibility and Compassion-Visiting the Housebound Patient Severely Affected by ME/CFS, Caroline Kingdon
Sample ME/CFS Disability Report, NeuroCognitive Research Institute: This is a quantitative case study of an ME/CFS patient
Podcast resource: Know M.E. (ANZMES, the Associated New Zealand Myalgic Encephalomyelitis Society)
Learn more about current ME/CFS and Long Covid research through the Solve M.E. Webinar Series, and sign up for our newsletter. You can also find a list of experts and thought leaders here. If you have any questions or need additional information, please contact us.
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