Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) and Long COVID: Shared Challenges and Opportunities in Chronic Disease Management

Objectives. Chronic non-communicable diseases (NCDs) represent an increasing global burden, projected to account for 86% of all annual deaths by 2050. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and
post-COVID-19 condition (long COVID) exemplify under-recognized, NCDs-related, high-burden chronic conditions that share overlapping symptoms and pathophysiological mechanisms. This scoping review aims to examine the epidemiological, biomedical, and socio-economic dimensions of ME/CFS and long COVID, with a focus on identifying challenges and opportunities for advancing research, prevention, and care.
Materials and Methods
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, systematically identifying studies from databases, grey literature, and key policy reports. Inclusion criteria focused on epidemiological data, pathophysiological
insights, and socio-economic impacts of ME/CFS and long COVID. Studies on common mechanisms, such as immune dysfunction, mitochondrial abnormalities, and autoimmunity, were emphasized. Additionally, integrative care models and social determinants of health were reviewed to map potential solutions.
Results
Results. ME/CFS and long COVID share significant symptom overlap, including chronic fatigue, post-exertional malaise, cognitive impairment, and autonomic dysfunction. Pathophysiological mechanisms involve immune dysregulation, mitochondrial dysfunction, and possible autoimmunity driven by molecular mimicry. Despite promising studies, research remains fragmented, and coordinated efforts are lacking. Socio-economic analysis reveals a substantial global economic burden, with long COVID alone contributing nearly one trillion USA dollars annually. Stigma and insufficient awareness exacerbate patients’ challenges, highlighting the need for improved education and integrative care approaches.
Conclusions
Conclusions. ME/CFS and long COVID exemplify emerging challenges in chronic disease management, underscoring the urgency for interdisciplinary research and patient-centered care. Addressing shared pathophysiological mechanisms could pave the way for targeted therapies, while integrative care models and robust epidemiological studies are essential for mitigating societal and economic impacts. Coordinated global efforts are
crucial to advancing the understanding, prevention, and management of these debilitating conditions. Project No. LZP-2024/1-0343