School of Public Health, Xiamen University, Xiamen 361000, China.
Department of Clinical Laboratory, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361000, China.
Int J Environ Res Public Health. 2023 Jan 30;20(3):2437. doi: 10.3390/ijerph20032437.
New clinical observational studies suggest that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a sequela of COVID-19 infection, but whether there is an exact causal relationship between COVID-19 and ME/CFS remains to be verified. To investigate whether infection with COVID-19 actually causes ME/CFS, this paper obtained pooled data from the Genome Wide Association Study (GWAS) and analyzed the relationship between COVID susceptibility, hospitalization and severity of COVID and ME/CFS, respectively, using two-sample Mendelian randomization (TSMR). TSMR analysis was performed by inverse variance weighting (IVW), weighted median method, MR-Egger regression and weighted mode and simple mode methods, respectively, and then the causal relationship between COVID-19 and ME/CFS was further evaluated by odds ratio (OR). Eventually, we found that COVID-19 severity, hospitalization and susceptibility were all not significantly correlated with ME/CFS (OR:1.000,1.000,1.000; 95% CI:0.999-1.000, 0.999-1.001, 0.998-1.002; = 0.333, 0.862, 0.998, respectively). We found the results to be reliable after sensitivity analysis. These results suggested that SARS-CoV-2 infection may not significantly contribute to the elevated risk of developing CFS, and therefore ME/CFS may not be a sequela of COVID-19, but may simply present with symptoms similar to those of CFS after COVID-19 infection, and thus should be judged and differentiated by physicians when diagnosing and treating the disease in clinical practice.
新的临床观察性研究表明,肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)是 COVID-19 感染的后遗症,但 COVID-19 和 ME/CFS 之间是否存在确切的因果关系仍有待验证。为了研究 COVID-19 感染是否确实会导致 ME/CFS,本文从全基因组关联研究(GWAS)中获取了汇总数据,并分别使用两样本孟德尔随机化(TSMR)分析了 COVID 易感性、住院和 COVID 严重程度与 ME/CFS 之间的关系。TSMR 分析分别采用逆方差加权(IVW)、加权中位数法、MR-Egger 回归和加权模式和简单模式方法,然后通过比值比(OR)进一步评估 COVID-19 与 ME/CFS 之间的因果关系。最终,我们发现 COVID-19 的严重程度、住院和易感性与 ME/CFS 均无显著相关性(OR:1.000、1.000、1.000;95%CI:0.999-1.000、0.999-1.001、0.998-1.002;=0.333、0.862、0.998,分别)。经过敏感性分析,我们发现结果是可靠的。这些结果表明,SARS-CoV-2 感染可能不会显著增加 CFS 的发病风险,因此 ME/CFS 可能不是 COVID-19 的后遗症,而可能只是在 COVID-19 感染后出现类似于 CFS 的症状,因此在临床实践中诊断和治疗疾病时,医生应进行判断和区分。