Fighting Post-COVID and ME/CFS – development of curative therapies
Carmen Scheibenbogen, Judith Bellmann–Strobl, Cornelia Heindrich, Kirsten Wittke, Elisa Stein, Christiana Franke, Harald Prüß, Hannah Preßler, Marie-Luise Machule, Heinrich J. Audebert, Carsten Finke, Hanna Zimmermann, Birgit Sawitzki, Christian Meisel, M. Toelle, Anne O. Krueger, Anna C. Aschenbrenner, Joachim L. Schultze, Marc Beyer, Markus Ralser, Michael Mülleder, Leif Erik Sander, Frank Konietschke, Friedemann Paul, Silvia Stojanov, Lisa Bruckert, Dennis M. Hedderich, Franziska Knolle, Gabriela Riemekasten, Maria J. G. T. Vehreschild, Oliver A. Cornely, Uta Behrends, Susen Burock
Abstract
The sequela of COVID-19 include a broad spectrum of symptoms that fall under the umbrella term post-COVID-19 condition or syndrome (PCS). Immune dysregulation, autoimmunity, endothelial dysfunction, viral persistence, and viral reactivation have been identified as potential mechanisms. However, there is heterogeneity in expression of biomarkers, and it is unknown yet whether these distinguish different clinical subgroups of PCS. There is an overlap of symptoms and pathomechanisms of PCS with postinfectious myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). No curative therapies are available for ME/CFS or PCS. The mechanisms identified so far provide targets for therapeutic interventions. To accelerate the development of therapies, we propose evaluating drugs targeting different mechanisms in clinical trial networks using harmonized diagnostic and outcome criteria and subgrouping patients based on a thorough clinical profiling including a comprehensive diagnostic and biomarker phenotyping.