Mialgiczne zapalenie mózgu i rdzenia/zespół przewlekłego zmęczenia

Mialgiczne zapalenie mózgu i rdzenia/zespół przewlekłego zmęczenia
Rokowania, prognozy i postęp choroby

Mialgiczne zapalenie mózgu i rdzenia/zespół przewlekłego zmęczenia (ME/CFS) to przewlekłe, wieloukładowe schorzenie o niekorzystnym rokowaniu, charakteryzujące się zmęczeniem trwającym ponad 6 miesięcy, nieustępującym po odpoczynku, złym samopoczuciem powysiłkowym (PEM), zaburzeniami snu, deficytami poznawczymi oraz nietolerancją ortostatyczną. Epidemiologicznie, około 1,8% populacji może spełniać kryteria ME/CFS, jednak aż 97,8% pozostaje nierozpoznanych klinicznie, co negatywnie wpływa na rokowanie. Wskaźniki całkowitego wyzdrowienia są niskie (0-8%), a poprawa kliniczna występuje u 17-64% pacjentów, z możliwością powrotu do pracy w niepełnym lub pełnym wymiarze godzin u około 50%. Czynniki prognostyczne obejmują wiek zachorowania (starszy wiek koreluje z lepszym rokowaniem, OR 1,06; p=0,028), opóźnienie diagnostyczne (krótsze opóźnienie sprzyja poprawie, OR 0,98; p=0,036), obecność infekcji i nawracających infekcji nasilających PEM (OR 2,1; p=0,009), a także współistniejące choroby, takie jak fibromialgia i zaburzenia psychiczne. Dzieci i młodzież wykazują lepsze rokowanie niż dorośli, z około 75% remisji w ciągu 2-3 lat.

Wprowadzenie do rokowania w mialgicznym zapaleniu mózgu i rdzenia/zespole przewlekłego zmęczenia (ME/CFS)
Wskaźniki wyzdrowienia i poprawy w ME/CFS

Wskaźniki wyzdrowienia
Wskaźniki poprawy klinicznej

Czynniki wpływające na rokowanie w ME/CFS

Wiek zachorowania
Opóźnienie diagnostyczne
Czynniki infekcyjne i nawracające infekcje
Choroby współistniejące
Czynniki psychologiczne

Rokowanie u dzieci i młodzieży z ME/CFS
Wpływ ME/CFS na funkcjonowanie zawodowe
Znaczenie wczesnej diagnozy i interwencji
Strategie postępowania wpływające na rokowanie
Podsumowanie i implikacje kliniczne

Kolejne rozdziały

Wprowadzenie do rokowania w mialgicznym zapaleniu mózgu i rdzenia/zespole przewlekłego zmęczenia (ME/CFS)

Mialgiczne zapalenie mózgu i rdzenia/zespół przewlekłego zmęczenia (ME/CFS) jest przewlekłym, wyniszczającym schorzeniem wieloukładowym o niekorzystnym rokowaniu długoterminowym.¹² Choroba wpływa na miliony ludzi na całym świecie, powodując znaczące ograniczenie zdolności do podejmowania aktywności sprzed zachorowania przez okres dłuższy niż sześć miesięcy, któremu towarzyszy zmęczenie o nowym lub wyraźnym początku, niewynikające z nadmiernego wysiłku i nieulegające złagodzeniu po odpoczynku, złe samopoczucie powysiłkowe, nieodświeżający sen oraz zaburzenia poznawcze lub nietolerancja ortostatyczna.³

Z dostępnych badań epidemiologicznych wynika, że ME/CFS pozostaje schorzeniem słabo rozumianym i często nierozpoznawanym w praktyce klinicznej.⁴ Według danych z Kaiser Permanente Northern California, zintegrowanego systemu opieki zdrowotnej obejmującego 2,7 miliona dorosłych członków, szacuje się, że około 1,8% pacjentów wykazywało objawy zgodne z ME/CFS w okresie dwuletnim, przy czym u 97,8% z nich nie odnotowano diagnozy ME/CFS w dokumentacji medycznej.⁵ Brak wczesnego rozpoznania ma istotny negatywny wpływ na rokowanie pacjentów.⁶

Wskaźniki wyzdrowienia i poprawy w ME/CFS

Wyniki badań naukowych jednoznacznie wskazują na niekorzystne rokowanie u pacjentów z ME/CFS.⁷⁸ Wskaźniki wyzdrowienia i poprawy znacząco różnią się w poszczególnych badaniach, jednak ogólny obraz wskazuje na przewlekły charakter schorzenia z niskim odsetkiem pełnego powrotu do zdrowia.⁹

Wskaźniki wyzdrowienia

Odsetek pacjentów z ME/CFS, którzy całkowicie wracają do zdrowia, nie jest dobrze udokumentowany w literaturze naukowej. W dostępnych badaniach wskaźniki wyzdrowienia wahają się od 0% do 8%.¹⁰ Część pacjentów może powrócić do pełnej funkcjonalności, jednak jest to stosunkowo rzadkie zjawisko w populacji chorych na ME/CFS.¹¹

Wskaźniki poprawy klinicznej

Wskaźniki poprawy klinicznej wykazują znacznie większą zmienność w porównaniu do wskaźników całkowitego wyzdrowienia i według badań wahają się od 17% do 64%.¹² Wielu pacjentów, u których nastąpiła poprawa, nadal doświadcza objawów, ale nie osiąga poziomu funkcjonowania sprzed choroby.¹³ Inni pacjenci, u których nastąpiła poprawa, kontynuują modyfikację swoich aktywności, aby utrzymać poprawę lub pozostać wolnymi od objawów.¹⁴

Jedno z prospektywnych badań sugeruje, że około 50% pacjentów z ME/CFS może powrócić do pracy w niepełnym lub pełnym wymiarze godzin.¹⁵ Warto jednak zauważyć, że remisje mogą być następowane przez nawroty choroby, a niektóre objawy nie ulegają poprawie lub wręcz pogarszają się z czasem.¹⁶¹⁷

Czynniki wpływające na rokowanie w ME/CFS

Zidentyfikowano szereg czynników epidemiologicznych i klinicznych, które mogą wpływać na rokowanie u pacjentów z ME/CFS. Poniżej przedstawiono najważniejsze z nich na podstawie dostępnych badań naukowych.

Wiek zachorowania

Interesującym odkryciem jest pozytywna korelacja między starszym wiekiem w momencie wystąpienia choroby a lepszymi wynikami leczenia.¹⁸¹⁹ Wieloczynnikowa analiza regresji binarnej wykazała, że starszy wiek w momencie wystąpienia choroby był związany z większym prawdopodobieństwem wyzdrowienia/poprawy (OR 1,06 [95% CI 1,007-1,110] (p = 0,028)).²⁰ To odkrycie daje nadzieję pacjentom na możliwość wyzdrowienia lub poprawy jakości życia nawet w zaawansowanym wieku.²¹²²

Jednakże w kontekście złego samopoczucia powysiłkowego (PEM), które jest kluczowym objawem ME/CFS, zaobserwowano bardziej nasilone objawy u starszych pacjentów w momencie wystąpienia choroby (OR 1,8 [95% CI 1,1-3,0] (p=0,03)).²³ Ten pozornie sprzeczny wynik może wskazywać na złożoność związku między wiekiem a rokowaniem w ME/CFS.

Opóźnienie diagnostyczne

Opóźnienie diagnostyczne jest jednym z najistotniejszych czynników prognostycznych w ME/CFS.²⁴ Badania wykazały, że opóźnienie diagnostyczne jest odwrotnie proporcjonalne do prawdopodobieństwa wyzdrowienia/poprawy (OR 0,98 [95% CI 0,964-0,996] (p = 0,036)).²⁵ Oznacza to, że krótsze opóźnienie diagnostyczne prognozuje lepsze wyniki u pacjentów z ME/CFS, co jest zgodne z wynikami wcześniejszych badań, które wykazały, że wskaźnik poprawy u pacjentów z długim czasem trwania dolegliwości jest niewielki, a dłuższy czas trwania choroby jest istotnym predyktorem złego rokowania.²⁶

Dane sugerują, że 53% osób z objawami przypominającymi ME/CFS bez udokumentowanej diagnozy zgłaszało, że zmęczenie rozpoczęło się mniej niż trzy lata wcześniej.²⁷ Wcześniejsza diagnoza ME/CFS przez klinicystów mogłaby ułatwić poprawę wyników i zapobiec progresji choroby w tej grupie.²⁸

Czynniki infekcyjne i nawracające infekcje

Wykazano, że czynniki infekcyjne i nawracające infekcje mają wpływ na przebieg ME/CFS, szczególnie w kontekście nasilenia złego samopoczucia powysiłkowego (PEM).²⁹ Cięższe PEM zaobserwowano u pacjentów, którzy cierpieli na nawracające infekcje w trakcie choroby (OR 2,1 [95% CI 1,2-3,7] (p=0,009)).³⁰

Szczególnie interesujące jest to, że gdy ME/CFS było wywołane przez czynnik zakaźny przewodu pokarmowego, obserwowano znacznie cięższe PEM (OR 5,7 [1,7-19,3] (p=0,006)).³¹ Biorąc pod uwagę, że PEM jest istotnie związane z niepełnosprawnością i prognozuje gorsze rokowanie dla pacjentów, zapobieganie jego występowaniu lub przynajmniej zmniejszenie jego nasilenia jest bardzo ważne, aby zapobiec zaostrzeniu choroby.³²

Choroby współistniejące

Obecność chorób współistniejących może również wpływać na rokowanie w ME/CFS. Gorsze rokowanie zgłaszano u pacjentów z ME/CFS z współistniejącym fibromialgia, a niektóre badania wykazały, że współistniejące choroby psychiczne są predyktorem złego wyniku leczenia ME/CFS.³³ Podobnie, dłuższy czas trwania choroby, ciężkie zmęczenie, współistniejąca depresja i lęk są czynnikami związanymi z gorszym rokowaniem.³⁴

Czynniki psychologiczne

Wśród czynników psychologicznych wpływających na rokowanie w ME/CFS warto wymienić poczucie kontroli nad objawami oraz brak przypisywania choroby przyczynom fizycznym.³⁵ Dobre wyniki są związane z mniejszym nasileniem zmęczenia na początku choroby, poczuciem kontroli nad objawami i brakiem przypisywania choroby przyczynom fizycznym.³⁶

Rokowanie u dzieci i młodzieży z ME/CFS

Rokowanie w ME/CFS wydaje się być korzystniejsze u dzieci i młodzieży w porównaniu do dorosłych.³⁷ Większość ekspertów zgadza się, że dzieci i nastolatki mają lepszą szansę na pełne lub częściowe wyzdrowienie z ME/CFS niż dorośli.³⁸

W dużej kohorcie nastolatków wykazano, że częstość występowania przewlekłego upośledzającego zmęczenia (CDF), które jest wskaźnikiem klinicznie rozpoznanego ME/CFS, wzrastała z wiekiem: od 1,47% w wieku 13 lat, poprzez 2,22% w wieku 16 lat, do 2,99% w wieku 18 lat.³⁹ Około 25% nastolatków wykazywało utrzymywanie się CDF w kolejnym punkcie czasowym, który następował po 2 (16-18) lub 3 (13-16) latach.⁴⁰

Co istotne, tylko 8,02% osób sklasyfikowanych jako mających CDF w wieku 13 lat nadal miało ten stan w wieku 16 i 18 lat, co sugeruje, że prawdopodobnie mieli CDF przez całą adolescencję.⁴¹ Dane te wskazują, że utrzymujące się CDF jest rzadkie u nastolatków, przy czym około 75% powraca do zdrowia po 2-3 latach.⁴²

Wpływ ME/CFS na funkcjonowanie zawodowe

ME/CFS może mieć znaczący wpływ na zdolność pacjentów do pracy i funkcjonowania zawodowego. Analiza wyników związanych z pracą wykazała, że 5 (35,7%) pacjentów w podgrupie 1 powróciło do zdrowia 6-24 miesięcy po otrzymaniu rekompensaty finansowej, a 1 pacjent (12,5%) w podgrupie 2 doświadczył znacznej poprawy 6 miesięcy po uznaniu za niepełnosprawnego pracownika i otrzymaniu renty inwalidzkiej.⁴³

Pomimo znacznego obciążenia chorobowością związaną z ME/CFS, nie ma dowodów na zwiększone ryzyko śmiertelności.⁴⁴ Jednakże długotrwałe konsekwencje choroby mogą prowadzić do znacznego pogorszenia jakości życia i funkcjonowania społecznego pacjentów.

Znaczenie wczesnej diagnozy i interwencji

Wyniki badań jednoznacznie wskazują na kluczowe znaczenie wczesnej diagnozy i odpowiedniego postępowania w ME/CFS dla poprawy rokowania.⁴⁵⁴⁶ Wydaje się zatem konieczne diagnozowanie i leczenie osób z ME/CFS tak wcześnie, jak to możliwe, aby zapobiec nasileniu objawów i poprawić rokowanie.⁴⁷

Znaczące niedodiagnozowanie ME/CFS jest powszechne pomimo wysokiego poziomu wykorzystania opieki zdrowotnej w zintegrowanych systemach opieki zdrowotnej.⁴⁸ Można wdrożyć kilka strategii w celu próby rozwiązania problemu niedodiagnozowania, w tym ciągły nadzór syndromiczny, szkolenia internetowe dla świadczeniodawców i pacjentów oraz szczegółowe informacje z zakresu zdrowia publicznego.⁴⁹

Poprawa rozpoznawania ME/CFS przez system medyczny ma kluczowe znaczenie dla opieki nad pacjentem i jego dobrego samopoczucia oraz może zmniejszyć chorobowość pacjentów dzięki wcześniejszemu rozpoznaniu i interwencji.⁵⁰

Strategie postępowania wpływające na rokowanie

Biorąc pod uwagę, że PEM jest istotnie związane z niepełnosprawnością i prognozuje gorsze wyniki dla pacjentów, zapobieganie jego występowaniu lub przynajmniej zmniejszanie jego nasilenia jest bardzo ważne, aby zapobiec zaostrzeniu choroby.⁵¹

Zapobieganie występowaniu PEM lub zmniejszanie jego nasilenia jest jednym z głównych celów strategii pacing (tempa aktywności), które okazały się skuteczne w postępowaniu w ME/CFS.⁵² Strategie te polegają na dostosowaniu poziomu aktywności pacjenta do jego indywidualnych możliwości energetycznych, unikając przekraczania progu, który mógłby wywołać PEM.

Obiecujące wyniki wykazano również w badaniu oceniającym wpływ 6-metylosulfinyloheksylo izotiocyjanianu (6-MSITC) u pacjentów z ME/CFS. Badanie sugeruje, że 6-MSITC poprawia tolerancję wysiłku fizycznego, a także subiektywne objawy, takie jak ból i dys funkcje poznawcze, oraz witalność psychologiczną pacjentów z ME/CFS. Poprawiał również funkcje poznawcze i zwiększał progi bólu u tych pacjentów, co może stanowić obiecującą opcję terapeutyczną, szczególnie dla poprawy dysfunkcji poznawczych związanych z ME/CFS.⁵³

Podsumowanie i implikacje kliniczne

Mialgiczne zapalenie mózgu i rdzenia/zespół przewlekłego zmęczenia (ME/CFS) charakteryzuje się ogólnie niekorzystnym rokowaniem z niskimi wskaźnikami całkowitego wyzdrowienia (0-8%) i zmiennymi wskaźnikami poprawy (17-64%).⁵⁴⁵⁵ Najważniejsze czynniki wpływające na rokowanie to:

Wiek w momencie zachorowania – starszy wiek wiąże się z lepszym rokowaniem⁵⁶⁵⁷
Opóźnienie diagnostyczne – krótsze opóźnienie wiąże się z lepszym rokowaniem⁵⁸⁵⁹
Czynniki infekcyjne i nawracające infekcje – wpływają na nasilenie PEM i rokowanie⁶⁰
Choroby współistniejące, w tym fibromialgię i zaburzenia psychiczne⁶¹
Czynniki psychologiczne, takie jak poczucie kontroli nad objawami⁶²

Dzieci i młodzież mają generalnie lepsze rokowanie niż dorośli, z wyższymi wskaźnikami wyzdrowienia.⁶³⁶⁴

Zrozumienie czynników wpływających na rokowanie w ME/CFS ma kluczowe znaczenie dla poprawy zarządzania chorobą i jakości życia pacjentów. Wczesna diagnoza i odpowiednie leczenie mogą znacząco wpłynąć na przebieg choroby i zapobiec jej progresji.⁶⁵⁶⁶ Dlatego też zwiększenie świadomości wśród pracowników służby zdrowia na temat ME/CFS jest kluczowe dla poprawy wyników leczenia pacjentów.⁶⁷

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] Studies that examined predictors of ME/CFS outcomes yielded contradictory results. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] A worse prognosis was reported in ME/CFS patients with comorbid fibromyalgia, and some studies showed that psychiatric comorbidity is predictive of poor CFS outcome.
#2 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#3 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic, debilitating multisystem illness that affects millions of people worldwide. The Institute of Medicine (IOM) 2015 diagnostic criteria require a substantial reduction in the ability to engage in pre-illness activity for more than six months, accompanied by fatigue of new or definite onset not resulting from excessive exertion and that is unrelieved by rest, post-exertional malaise, unrefreshing sleep, and either cognitive impairment or orthostatic intolerance. Prior studies have suggested that most ME/CFS patients are undiagnosed, and the number of people with undiagnosed ME/CFS may have recently increased given ME/CFS is a possible outcome of SARS-CoV-2 infection. Understanding the extent of ME/CFS underdiagnosis is crucial for mobilizing action to improve identification and subsequent care for those with ME/CFS. We estimate the prevalence of undiagnosed ME/CFS-like illness in a large, integrated healthcare system over a two-year study period, compare demographics, healthcare utilization, and health-related quality of life among undiagnosed and diagnosed persons, and suggest measures that could improve rates of diagnosis.
#4 Recent research in myalgic encephalomyelitis/chronic fatigue syndrome: an evidence map | NIHR Journals Library
https://www.journalslibrary.nihr.ac.uk/hta/published-articles/BTBD8846
The ME/CFS remains a poorly understood condition. […] The lack of high-quality systematic reviews in this field, given the large numbers of primary studies, is a key limitation. […] The use of, and reporting of, diagnostic criteria for ME/CFS within these studies varied enormously, and the lack of consistency provides challenges to the synthesis and interpretation of evidence in this field. […] Our evidence map demonstrates that there are studies which are relevant to all of the JLA top 10+ research questions. […] The evidence base is currently substantially limited by inconsistencies and variations in diagnostic criteria and terminology. […] Gaining international consensus over diagnostic criteria is arguably a fundamental and urgent step prior to further research relating to diagnostic testing.
#5 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
ME/CFS is underdiagnosed in the Kaiser Permanente Northern California healthcare system. Enhanced syndromic surveillance that characterizes patients with ME/CFS who have not been diagnosed has the potential to increase timely recognition of ME/CFS. […] In an integrated healthcare system with 2.7 million adult members, an estimated 1.8% had symptoms consistent with ME/CFS-like illness during a two-year period. Of those with ME/CFS-like illness, 97.8% had no documentation of an ME/CFS diagnosis, despite a high level of primary care utilization; 53% of those with ME/CFS-like illness and no EHR diagnosis reported fatigue began less than three years prior. These findings suggest that many people with ME/CFS are not recognized, particularly those with recent onset. Earlier diagnosis of ME/CFS by clinicians might facilitate improvement in outcomes and prevention of disease progression for this group.
#6 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
The purpose of this study was to explore epidemiological and clinical factors that could influence the prognosis of ME/CFS subjects. […] The analysis of the controversial role of age of onset as a prognostic factor found a statistically significant positive association between age at onset and better outcomes among ME/CFS patients. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature. […] It therefore seems necessary to diagnose and manage people with ME/CFS as early as possible to prevent worsening of symptoms and improve prognosis.
#7 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#8 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Certain symptoms may persist or worsen over time. […] Individuals with ME/CFS have a poor prognosis with low rates of recovery or improvement. […] The study revealed that ME/CFS patients have a poor prognosis with low rates of recovery or improvement. It found that older patients with ME/CFS have better outcomes compared to younger patients. […] Diagnostic delays were linked to a poorer prognosis, underscoring the importance of early diagnosis and management. Increased awareness among healthcare providers about ME/CFS is crucial for enhancing patient outcomes.
#9 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] Studies that examined predictors of ME/CFS outcomes yielded contradictory results. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] A worse prognosis was reported in ME/CFS patients with comorbid fibromyalgia, and some studies showed that psychiatric comorbidity is predictive of poor CFS outcome.
#10 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#11 Clinical Overview of ME/CFS | ME/CFS | CDC
https://www.cdc.gov/me-cfs/hcp/clinical-overview/index.html
The percentage of ME/CFS patients who recover is not well-studied. However, there is evidence and experience that early diagnosis and timely and appropriate management may play a role. […] Some patients return to full function. Many who improve continue to have symptoms but do not achieve pre-illness levels of function. Others who improve continue to modify their activities to remain improved or free of symptoms. Remissions occur but can be followed by relapses. Some symptoms do not improve or, in fact, worsen over time. […] However, most experts agree that children and teenagers have a better chance of full or partial recovery from ME/CFS than adults.
#12 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#13 Clinical Overview of ME/CFS | ME/CFS | CDC
https://www.cdc.gov/me-cfs/hcp/clinical-overview/index.html
The percentage of ME/CFS patients who recover is not well-studied. However, there is evidence and experience that early diagnosis and timely and appropriate management may play a role. […] Some patients return to full function. Many who improve continue to have symptoms but do not achieve pre-illness levels of function. Others who improve continue to modify their activities to remain improved or free of symptoms. Remissions occur but can be followed by relapses. Some symptoms do not improve or, in fact, worsen over time. […] However, most experts agree that children and teenagers have a better chance of full or partial recovery from ME/CFS than adults.
#14 Clinical Overview of ME/CFS | ME/CFS | CDC
https://www.cdc.gov/me-cfs/hcp/clinical-overview/index.html
The percentage of ME/CFS patients who recover is not well-studied. However, there is evidence and experience that early diagnosis and timely and appropriate management may play a role. […] Some patients return to full function. Many who improve continue to have symptoms but do not achieve pre-illness levels of function. Others who improve continue to modify their activities to remain improved or free of symptoms. Remissions occur but can be followed by relapses. Some symptoms do not improve or, in fact, worsen over time. […] However, most experts agree that children and teenagers have a better chance of full or partial recovery from ME/CFS than adults.
#15 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has no cure, its symptoms can persist for years, and its clinical course is punctuated by remissions and relapses. One prospective study suggests that approximately 50% of patients with ME/CFS can return to part-time or full-time work. […] Longer duration of illness, severe fatigue, comorbid depression, and anxiety are factors associated with a poorer prognosis. […] Good outcomes are associated with less fatigue severity at baseline, a sense of control over symptoms, and no attribution of the illness to a physical cause. […] Despite the considerable burden of morbidity associated with ME/CFS, there is no evidence of an increased risk for mortality. […] Recovery rates for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are not well-documented, but early diagnosis and appropriate management may be influential. Some patients recover fully, whereas others show improvement but do not return to their pre-illness levels of function.
#16 Clinical Overview of ME/CFS | ME/CFS | CDC
https://www.cdc.gov/me-cfs/hcp/clinical-overview/index.html
The percentage of ME/CFS patients who recover is not well-studied. However, there is evidence and experience that early diagnosis and timely and appropriate management may play a role. […] Some patients return to full function. Many who improve continue to have symptoms but do not achieve pre-illness levels of function. Others who improve continue to modify their activities to remain improved or free of symptoms. Remissions occur but can be followed by relapses. Some symptoms do not improve or, in fact, worsen over time. […] However, most experts agree that children and teenagers have a better chance of full or partial recovery from ME/CFS than adults.
#17 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Certain symptoms may persist or worsen over time. […] Individuals with ME/CFS have a poor prognosis with low rates of recovery or improvement. […] The study revealed that ME/CFS patients have a poor prognosis with low rates of recovery or improvement. It found that older patients with ME/CFS have better outcomes compared to younger patients. […] Diagnostic delays were linked to a poorer prognosis, underscoring the importance of early diagnosis and management. Increased awareness among healthcare providers about ME/CFS is crucial for enhancing patient outcomes.
#18 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#19 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
The purpose of this study was to explore epidemiological and clinical factors that could influence the prognosis of ME/CFS subjects. […] The analysis of the controversial role of age of onset as a prognostic factor found a statistically significant positive association between age at onset and better outcomes among ME/CFS patients. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature. […] It therefore seems necessary to diagnose and manage people with ME/CFS as early as possible to prevent worsening of symptoms and improve prognosis.
#20 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#21 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
This finding, suggesting that a shorter diagnostic delay predicts better outcomes in ME/CFS patients, is consistent with the results of prior studies, which observed that the improvement rate in patients with a long duration of complaints is small and that longer illness duration is a significant predictor of poor prognosis. […] The analysis of work-related outcomes showed that 5 (35.7%) patients in subgroup 1 were recovered 624 months after receiving financial compensation and 1 patient (12.5%) in subgroup 2 experienced significant improvement 6 months after being recognized as a disabled worker and receiving a disability pension. […] Our study revealed low recovery/improvement rates emphasizing the poor prognosis of ME/CFS patients. […] This finding could offer hope to older ME/CFS patients for the prospect of recovery or improvement with better quality of life, even at an advanced age. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature.
#22 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Certain symptoms may persist or worsen over time. […] Individuals with ME/CFS have a poor prognosis with low rates of recovery or improvement. […] The study revealed that ME/CFS patients have a poor prognosis with low rates of recovery or improvement. It found that older patients with ME/CFS have better outcomes compared to younger patients. […] Diagnostic delays were linked to a poorer prognosis, underscoring the importance of early diagnosis and management. Increased awareness among healthcare providers about ME/CFS is crucial for enhancing patient outcomes.
#23 Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02419-4
PEM severity was found to be positively associated with age at disease onset32 years (OR 1.8 [95% CI 1.13.0] (p=0.03)), recurrent infections during the course of the disease (OR 2.1 [95% CI 1.23.7] (p=0.009)), and when ME/CFS was elicited by a gastrointestinal infectious precipitant (OR 5.7 [1.719.3] (p=0.006)). […] We identified some epidemiological and clinical features, which were positively associated with PEM severity in subsets of ME/CFS patients. This could help improving disease management and patients quality of life. […] In the absence of ME/CFS treatment and given the fact that PEM was found to be significantly associated with disability and predict a poorer outcome for patients, the prevention of its occurrence, or at least reducing its severity, is very important to prevent disease exacerbation.
#24 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
The purpose of this study was to explore epidemiological and clinical factors that could influence the prognosis of ME/CFS subjects. […] The analysis of the controversial role of age of onset as a prognostic factor found a statistically significant positive association between age at onset and better outcomes among ME/CFS patients. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature. […] It therefore seems necessary to diagnose and manage people with ME/CFS as early as possible to prevent worsening of symptoms and improve prognosis.
#25 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#26 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
This finding, suggesting that a shorter diagnostic delay predicts better outcomes in ME/CFS patients, is consistent with the results of prior studies, which observed that the improvement rate in patients with a long duration of complaints is small and that longer illness duration is a significant predictor of poor prognosis. […] The analysis of work-related outcomes showed that 5 (35.7%) patients in subgroup 1 were recovered 624 months after receiving financial compensation and 1 patient (12.5%) in subgroup 2 experienced significant improvement 6 months after being recognized as a disabled worker and receiving a disability pension. […] Our study revealed low recovery/improvement rates emphasizing the poor prognosis of ME/CFS patients. […] This finding could offer hope to older ME/CFS patients for the prospect of recovery or improvement with better quality of life, even at an advanced age. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature.
#27 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
ME/CFS is underdiagnosed in the Kaiser Permanente Northern California healthcare system. Enhanced syndromic surveillance that characterizes patients with ME/CFS who have not been diagnosed has the potential to increase timely recognition of ME/CFS. […] In an integrated healthcare system with 2.7 million adult members, an estimated 1.8% had symptoms consistent with ME/CFS-like illness during a two-year period. Of those with ME/CFS-like illness, 97.8% had no documentation of an ME/CFS diagnosis, despite a high level of primary care utilization; 53% of those with ME/CFS-like illness and no EHR diagnosis reported fatigue began less than three years prior. These findings suggest that many people with ME/CFS are not recognized, particularly those with recent onset. Earlier diagnosis of ME/CFS by clinicians might facilitate improvement in outcomes and prevention of disease progression for this group.
#28 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
ME/CFS is underdiagnosed in the Kaiser Permanente Northern California healthcare system. Enhanced syndromic surveillance that characterizes patients with ME/CFS who have not been diagnosed has the potential to increase timely recognition of ME/CFS. […] In an integrated healthcare system with 2.7 million adult members, an estimated 1.8% had symptoms consistent with ME/CFS-like illness during a two-year period. Of those with ME/CFS-like illness, 97.8% had no documentation of an ME/CFS diagnosis, despite a high level of primary care utilization; 53% of those with ME/CFS-like illness and no EHR diagnosis reported fatigue began less than three years prior. These findings suggest that many people with ME/CFS are not recognized, particularly those with recent onset. Earlier diagnosis of ME/CFS by clinicians might facilitate improvement in outcomes and prevention of disease progression for this group.
#29 Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02419-4
PEM severity was found to be positively associated with age at disease onset32 years (OR 1.8 [95% CI 1.13.0] (p=0.03)), recurrent infections during the course of the disease (OR 2.1 [95% CI 1.23.7] (p=0.009)), and when ME/CFS was elicited by a gastrointestinal infectious precipitant (OR 5.7 [1.719.3] (p=0.006)). […] We identified some epidemiological and clinical features, which were positively associated with PEM severity in subsets of ME/CFS patients. This could help improving disease management and patients quality of life. […] In the absence of ME/CFS treatment and given the fact that PEM was found to be significantly associated with disability and predict a poorer outcome for patients, the prevention of its occurrence, or at least reducing its severity, is very important to prevent disease exacerbation.
#30 Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02419-4
PEM severity was found to be positively associated with age at disease onset32 years (OR 1.8 [95% CI 1.13.0] (p=0.03)), recurrent infections during the course of the disease (OR 2.1 [95% CI 1.23.7] (p=0.009)), and when ME/CFS was elicited by a gastrointestinal infectious precipitant (OR 5.7 [1.719.3] (p=0.006)). […] We identified some epidemiological and clinical features, which were positively associated with PEM severity in subsets of ME/CFS patients. This could help improving disease management and patients quality of life. […] In the absence of ME/CFS treatment and given the fact that PEM was found to be significantly associated with disability and predict a poorer outcome for patients, the prevention of its occurrence, or at least reducing its severity, is very important to prevent disease exacerbation.
#31 Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02419-4
PEM severity was found to be positively associated with age at disease onset32 years (OR 1.8 [95% CI 1.13.0] (p=0.03)), recurrent infections during the course of the disease (OR 2.1 [95% CI 1.23.7] (p=0.009)), and when ME/CFS was elicited by a gastrointestinal infectious precipitant (OR 5.7 [1.719.3] (p=0.006)). […] We identified some epidemiological and clinical features, which were positively associated with PEM severity in subsets of ME/CFS patients. This could help improving disease management and patients quality of life. […] In the absence of ME/CFS treatment and given the fact that PEM was found to be significantly associated with disability and predict a poorer outcome for patients, the prevention of its occurrence, or at least reducing its severity, is very important to prevent disease exacerbation.
#32 Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02419-4
PEM severity was found to be positively associated with age at disease onset32 years (OR 1.8 [95% CI 1.13.0] (p=0.03)), recurrent infections during the course of the disease (OR 2.1 [95% CI 1.23.7] (p=0.009)), and when ME/CFS was elicited by a gastrointestinal infectious precipitant (OR 5.7 [1.719.3] (p=0.006)). […] We identified some epidemiological and clinical features, which were positively associated with PEM severity in subsets of ME/CFS patients. This could help improving disease management and patients quality of life. […] In the absence of ME/CFS treatment and given the fact that PEM was found to be significantly associated with disability and predict a poorer outcome for patients, the prevention of its occurrence, or at least reducing its severity, is very important to prevent disease exacerbation.
#33 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] Studies that examined predictors of ME/CFS outcomes yielded contradictory results. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] A worse prognosis was reported in ME/CFS patients with comorbid fibromyalgia, and some studies showed that psychiatric comorbidity is predictive of poor CFS outcome.
#34 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has no cure, its symptoms can persist for years, and its clinical course is punctuated by remissions and relapses. One prospective study suggests that approximately 50% of patients with ME/CFS can return to part-time or full-time work. […] Longer duration of illness, severe fatigue, comorbid depression, and anxiety are factors associated with a poorer prognosis. […] Good outcomes are associated with less fatigue severity at baseline, a sense of control over symptoms, and no attribution of the illness to a physical cause. […] Despite the considerable burden of morbidity associated with ME/CFS, there is no evidence of an increased risk for mortality. […] Recovery rates for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are not well-documented, but early diagnosis and appropriate management may be influential. Some patients recover fully, whereas others show improvement but do not return to their pre-illness levels of function.
#35 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has no cure, its symptoms can persist for years, and its clinical course is punctuated by remissions and relapses. One prospective study suggests that approximately 50% of patients with ME/CFS can return to part-time or full-time work. […] Longer duration of illness, severe fatigue, comorbid depression, and anxiety are factors associated with a poorer prognosis. […] Good outcomes are associated with less fatigue severity at baseline, a sense of control over symptoms, and no attribution of the illness to a physical cause. […] Despite the considerable burden of morbidity associated with ME/CFS, there is no evidence of an increased risk for mortality. […] Recovery rates for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are not well-documented, but early diagnosis and appropriate management may be influential. Some patients recover fully, whereas others show improvement but do not return to their pre-illness levels of function.
#36 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has no cure, its symptoms can persist for years, and its clinical course is punctuated by remissions and relapses. One prospective study suggests that approximately 50% of patients with ME/CFS can return to part-time or full-time work. […] Longer duration of illness, severe fatigue, comorbid depression, and anxiety are factors associated with a poorer prognosis. […] Good outcomes are associated with less fatigue severity at baseline, a sense of control over symptoms, and no attribution of the illness to a physical cause. […] Despite the considerable burden of morbidity associated with ME/CFS, there is no evidence of an increased risk for mortality. […] Recovery rates for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are not well-documented, but early diagnosis and appropriate management may be influential. Some patients recover fully, whereas others show improvement but do not return to their pre-illness levels of function.
#37 Clinical Overview of ME/CFS | ME/CFS | CDC
https://www.cdc.gov/me-cfs/hcp/clinical-overview/index.html
The percentage of ME/CFS patients who recover is not well-studied. However, there is evidence and experience that early diagnosis and timely and appropriate management may play a role. […] Some patients return to full function. Many who improve continue to have symptoms but do not achieve pre-illness levels of function. Others who improve continue to modify their activities to remain improved or free of symptoms. Remissions occur but can be followed by relapses. Some symptoms do not improve or, in fact, worsen over time. […] However, most experts agree that children and teenagers have a better chance of full or partial recovery from ME/CFS than adults.
#38 Clinical Overview of ME/CFS | ME/CFS | CDC
https://www.cdc.gov/me-cfs/hcp/clinical-overview/index.html
The percentage of ME/CFS patients who recover is not well-studied. However, there is evidence and experience that early diagnosis and timely and appropriate management may play a role. […] Some patients return to full function. Many who improve continue to have symptoms but do not achieve pre-illness levels of function. Others who improve continue to modify their activities to remain improved or free of symptoms. Remissions occur but can be followed by relapses. Some symptoms do not improve or, in fact, worsen over time. […] However, most experts agree that children and teenagers have a better chance of full or partial recovery from ME/CFS than adults.
#39 Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents | Archives of Disease in Childhood
https://adc.bmj.com/content/102/6/522
The prevalence of chronic disabling fatigue (CDF), a proxy for clinically diagnosed CFS/ME, increases during adolescence. Approximately 25% persist over a 2-3 year follow-up. Only 8% of children with CDF at age 13 had CDF at 16 and 18 years. […] The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years. […] We have shown that, in a large cohort of adolescents, the prevalence of CDF increased with advancing age, so that, using imputed results, 1.47% of adolescents had the condition at 13, increasing to 2.22% at 16 years and 2.99% at 18 years. Approximately 25% of adolescents showed persistence of CDF at the subsequent time point, which was 2 (16-18) or 3 (13-16) years later. 8.02% of those classified as having the condition at 13 would still have the condition at 16 and 18, suggesting that they probably had CDF throughout adolescence.
#40 Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents | Archives of Disease in Childhood
https://adc.bmj.com/content/102/6/522
The prevalence of chronic disabling fatigue (CDF), a proxy for clinically diagnosed CFS/ME, increases during adolescence. Approximately 25% persist over a 2-3 year follow-up. Only 8% of children with CDF at age 13 had CDF at 16 and 18 years. […] The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years. […] We have shown that, in a large cohort of adolescents, the prevalence of CDF increased with advancing age, so that, using imputed results, 1.47% of adolescents had the condition at 13, increasing to 2.22% at 16 years and 2.99% at 18 years. Approximately 25% of adolescents showed persistence of CDF at the subsequent time point, which was 2 (16-18) or 3 (13-16) years later. 8.02% of those classified as having the condition at 13 would still have the condition at 16 and 18, suggesting that they probably had CDF throughout adolescence.
#41 Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents | Archives of Disease in Childhood
https://adc.bmj.com/content/102/6/522
The prevalence of chronic disabling fatigue (CDF), a proxy for clinically diagnosed CFS/ME, increases during adolescence. Approximately 25% persist over a 2-3 year follow-up. Only 8% of children with CDF at age 13 had CDF at 16 and 18 years. […] The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years. […] We have shown that, in a large cohort of adolescents, the prevalence of CDF increased with advancing age, so that, using imputed results, 1.47% of adolescents had the condition at 13, increasing to 2.22% at 16 years and 2.99% at 18 years. Approximately 25% of adolescents showed persistence of CDF at the subsequent time point, which was 2 (16-18) or 3 (13-16) years later. 8.02% of those classified as having the condition at 13 would still have the condition at 16 and 18, suggesting that they probably had CDF throughout adolescence.
#42 Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents | Archives of Disease in Childhood
https://adc.bmj.com/content/102/6/522
The prevalence of chronic disabling fatigue (CDF), a proxy for clinically diagnosed CFS/ME, increases during adolescence. Approximately 25% persist over a 2-3 year follow-up. Only 8% of children with CDF at age 13 had CDF at 16 and 18 years. […] The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years. […] We have shown that, in a large cohort of adolescents, the prevalence of CDF increased with advancing age, so that, using imputed results, 1.47% of adolescents had the condition at 13, increasing to 2.22% at 16 years and 2.99% at 18 years. Approximately 25% of adolescents showed persistence of CDF at the subsequent time point, which was 2 (16-18) or 3 (13-16) years later. 8.02% of those classified as having the condition at 13 would still have the condition at 16 and 18, suggesting that they probably had CDF throughout adolescence.
#43 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
This finding, suggesting that a shorter diagnostic delay predicts better outcomes in ME/CFS patients, is consistent with the results of prior studies, which observed that the improvement rate in patients with a long duration of complaints is small and that longer illness duration is a significant predictor of poor prognosis. […] The analysis of work-related outcomes showed that 5 (35.7%) patients in subgroup 1 were recovered 624 months after receiving financial compensation and 1 patient (12.5%) in subgroup 2 experienced significant improvement 6 months after being recognized as a disabled worker and receiving a disability pension. […] Our study revealed low recovery/improvement rates emphasizing the poor prognosis of ME/CFS patients. […] This finding could offer hope to older ME/CFS patients for the prospect of recovery or improvement with better quality of life, even at an advanced age. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature.
#44 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has no cure, its symptoms can persist for years, and its clinical course is punctuated by remissions and relapses. One prospective study suggests that approximately 50% of patients with ME/CFS can return to part-time or full-time work. […] Longer duration of illness, severe fatigue, comorbid depression, and anxiety are factors associated with a poorer prognosis. […] Good outcomes are associated with less fatigue severity at baseline, a sense of control over symptoms, and no attribution of the illness to a physical cause. […] Despite the considerable burden of morbidity associated with ME/CFS, there is no evidence of an increased risk for mortality. […] Recovery rates for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are not well-documented, but early diagnosis and appropriate management may be influential. Some patients recover fully, whereas others show improvement but do not return to their pre-illness levels of function.
#45 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
The purpose of this study was to explore epidemiological and clinical factors that could influence the prognosis of ME/CFS subjects. […] The analysis of the controversial role of age of onset as a prognostic factor found a statistically significant positive association between age at onset and better outcomes among ME/CFS patients. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature. […] It therefore seems necessary to diagnose and manage people with ME/CFS as early as possible to prevent worsening of symptoms and improve prognosis.
#46 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
The results suggest that underdiagnosis of ME/CFS is common despite high levels of care utilization in the Kaiser Permanente Northern California integrated healthcare system. Several strategies could be implemented to attempt to address underdiagnosis, including continued syndromic surveillance, web-based training for providers and patients, and public health detailing. Improved ascertainment of ME/CFS by the medical system is critical for patient care and well-being and has the potential to decrease patient morbidity from ME/CFS through earlier recognition and intervention.
#47 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
The purpose of this study was to explore epidemiological and clinical factors that could influence the prognosis of ME/CFS subjects. […] The analysis of the controversial role of age of onset as a prognostic factor found a statistically significant positive association between age at onset and better outcomes among ME/CFS patients. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature. […] It therefore seems necessary to diagnose and manage people with ME/CFS as early as possible to prevent worsening of symptoms and improve prognosis.
#48 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
The results suggest that underdiagnosis of ME/CFS is common despite high levels of care utilization in the Kaiser Permanente Northern California integrated healthcare system. Several strategies could be implemented to attempt to address underdiagnosis, including continued syndromic surveillance, web-based training for providers and patients, and public health detailing. Improved ascertainment of ME/CFS by the medical system is critical for patient care and well-being and has the potential to decrease patient morbidity from ME/CFS through earlier recognition and intervention.
#49 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
The results suggest that underdiagnosis of ME/CFS is common despite high levels of care utilization in the Kaiser Permanente Northern California integrated healthcare system. Several strategies could be implemented to attempt to address underdiagnosis, including continued syndromic surveillance, web-based training for providers and patients, and public health detailing. Improved ascertainment of ME/CFS by the medical system is critical for patient care and well-being and has the potential to decrease patient morbidity from ME/CFS through earlier recognition and intervention.
#50 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
The results suggest that underdiagnosis of ME/CFS is common despite high levels of care utilization in the Kaiser Permanente Northern California integrated healthcare system. Several strategies could be implemented to attempt to address underdiagnosis, including continued syndromic surveillance, web-based training for providers and patients, and public health detailing. Improved ascertainment of ME/CFS by the medical system is critical for patient care and well-being and has the potential to decrease patient morbidity from ME/CFS through earlier recognition and intervention.
#51 Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02419-4
PEM severity was found to be positively associated with age at disease onset32 years (OR 1.8 [95% CI 1.13.0] (p=0.03)), recurrent infections during the course of the disease (OR 2.1 [95% CI 1.23.7] (p=0.009)), and when ME/CFS was elicited by a gastrointestinal infectious precipitant (OR 5.7 [1.719.3] (p=0.006)). […] We identified some epidemiological and clinical features, which were positively associated with PEM severity in subsets of ME/CFS patients. This could help improving disease management and patients quality of life. […] In the absence of ME/CFS treatment and given the fact that PEM was found to be significantly associated with disability and predict a poorer outcome for patients, the prevention of its occurrence, or at least reducing its severity, is very important to prevent disease exacerbation.
#52 Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02419-4
The prevention of PEM occurrence or reducing its severity is thus one of the main goals of pacing strategies, which proved successful in ME/CFS management. […] We observed more severe PEM in older patients at disease onset, and among those who were suffering from recurrent infections during their disease course. More severe PEM was also observed in patients in whom ME/CFS onset was preceded by GI infectious precipitants.
#53 ME/CFS and Long Covid Research: 05 â 12 December 2022Â – The ME Association
https://meassociation.org.uk/2022/12/me-cfs-research-published-5-12-december-2022/
Muscle sodium content before and after exercise was higher in ME/CFS than in healthy controls. Furthermore, our findings indicate an inverse correlation between muscle sodium content and handgrip strength. […] Our results indicate that those with a diagnosis of ME/CFS are characterized by an impaired ability for physical or mental exertion, worse pain, and poorer overall health as compared to individuals with similar symptoms but for whom ME/CFS-diagnosis was not established. […] This study suggests that 6-MSITC improves PS as well as subjective symptoms such as pain and cognitive dysfunction, and psychological vitality of patients with ME/CFS. It also improved cognitive performance and increased pain thresholds in these patients. 6-MSITC may be a promising therapeutic option especially for improving cognitive dysfunction associated with ME/CFS.
#54 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#55 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has no cure, its symptoms can persist for years, and its clinical course is punctuated by remissions and relapses. One prospective study suggests that approximately 50% of patients with ME/CFS can return to part-time or full-time work. […] Longer duration of illness, severe fatigue, comorbid depression, and anxiety are factors associated with a poorer prognosis. […] Good outcomes are associated with less fatigue severity at baseline, a sense of control over symptoms, and no attribution of the illness to a physical cause. […] Despite the considerable burden of morbidity associated with ME/CFS, there is no evidence of an increased risk for mortality. […] Recovery rates for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are not well-documented, but early diagnosis and appropriate management may be influential. Some patients recover fully, whereas others show improvement but do not return to their pre-illness levels of function.
#56 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#57 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
The purpose of this study was to explore epidemiological and clinical factors that could influence the prognosis of ME/CFS subjects. […] The analysis of the controversial role of age of onset as a prognostic factor found a statistically significant positive association between age at onset and better outcomes among ME/CFS patients. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature. […] It therefore seems necessary to diagnose and manage people with ME/CFS as early as possible to prevent worsening of symptoms and improve prognosis.
#58 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] Likewise, a broad range of improvement rates from 17% to 64% was reported according to studies. […] The multivariate binary regression analysis showed that older age at disease onset was associated with R/I (OR 1.06 [95% CI 1.0071.110] (p = 0.028)), while the diagnostic delay was inversely associated with R/I (OR 0.98 [95% CI 0.9640.996] (p = 0.036)).
#59 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
The purpose of this study was to explore epidemiological and clinical factors that could influence the prognosis of ME/CFS subjects. […] The analysis of the controversial role of age of onset as a prognostic factor found a statistically significant positive association between age at onset and better outcomes among ME/CFS patients. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature. […] It therefore seems necessary to diagnose and manage people with ME/CFS as early as possible to prevent worsening of symptoms and improve prognosis.
#60 Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02419-4
PEM severity was found to be positively associated with age at disease onset32 years (OR 1.8 [95% CI 1.13.0] (p=0.03)), recurrent infections during the course of the disease (OR 2.1 [95% CI 1.23.7] (p=0.009)), and when ME/CFS was elicited by a gastrointestinal infectious precipitant (OR 5.7 [1.719.3] (p=0.006)). […] We identified some epidemiological and clinical features, which were positively associated with PEM severity in subsets of ME/CFS patients. This could help improving disease management and patients quality of life. […] In the absence of ME/CFS treatment and given the fact that PEM was found to be significantly associated with disability and predict a poorer outcome for patients, the prevention of its occurrence, or at least reducing its severity, is very important to prevent disease exacerbation.
#61 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating multisystem condition with poor prognosis. […] Studies that examined predictors of ME/CFS outcomes yielded contradictory results. […] The study findings confirmed the poor prognosis of ME/CFS and the deleterious effect of diagnostic delay on disease progression. […] Interestingly, being older at disease onset was associated with better outcomes, which offers hope to patients for recovery/improvement even at an advanced age. […] Although recovery and improvement rates varied widely across different studies, almost all studies agree that ME/CFS prognosis is rather unfavorable. […] The reported recovery rates ranged from 0% to 8%. […] A worse prognosis was reported in ME/CFS patients with comorbid fibromyalgia, and some studies showed that psychiatric comorbidity is predictive of poor CFS outcome.
#62 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has no cure, its symptoms can persist for years, and its clinical course is punctuated by remissions and relapses. One prospective study suggests that approximately 50% of patients with ME/CFS can return to part-time or full-time work. […] Longer duration of illness, severe fatigue, comorbid depression, and anxiety are factors associated with a poorer prognosis. […] Good outcomes are associated with less fatigue severity at baseline, a sense of control over symptoms, and no attribution of the illness to a physical cause. […] Despite the considerable burden of morbidity associated with ME/CFS, there is no evidence of an increased risk for mortality. […] Recovery rates for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are not well-documented, but early diagnosis and appropriate management may be influential. Some patients recover fully, whereas others show improvement but do not return to their pre-illness levels of function.
#63 Clinical Overview of ME/CFS | ME/CFS | CDC
https://www.cdc.gov/me-cfs/hcp/clinical-overview/index.html
The percentage of ME/CFS patients who recover is not well-studied. However, there is evidence and experience that early diagnosis and timely and appropriate management may play a role. […] Some patients return to full function. Many who improve continue to have symptoms but do not achieve pre-illness levels of function. Others who improve continue to modify their activities to remain improved or free of symptoms. Remissions occur but can be followed by relapses. Some symptoms do not improve or, in fact, worsen over time. […] However, most experts agree that children and teenagers have a better chance of full or partial recovery from ME/CFS than adults.
#64 Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents | Archives of Disease in Childhood
https://adc.bmj.com/content/102/6/522
The prevalence of chronic disabling fatigue (CDF), a proxy for clinically diagnosed CFS/ME, increases during adolescence. Approximately 25% persist over a 2-3 year follow-up. Only 8% of children with CDF at age 13 had CDF at 16 and 18 years. […] The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years. […] We have shown that, in a large cohort of adolescents, the prevalence of CDF increased with advancing age, so that, using imputed results, 1.47% of adolescents had the condition at 13, increasing to 2.22% at 16 years and 2.99% at 18 years. Approximately 25% of adolescents showed persistence of CDF at the subsequent time point, which was 2 (16-18) or 3 (13-16) years later. 8.02% of those classified as having the condition at 13 would still have the condition at 16 and 18, suggesting that they probably had CDF throughout adolescence.
#65 Factors Influencing the Prognosis of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
https://www.mdpi.com/2075-4418/12/10/2540
The purpose of this study was to explore epidemiological and clinical factors that could influence the prognosis of ME/CFS subjects. […] The analysis of the controversial role of age of onset as a prognostic factor found a statistically significant positive association between age at onset and better outcomes among ME/CFS patients. […] In addition, our analysis showed that diagnostic delay predicts poor prognosis for ME/CFS patients, which is consistent with the body of evidence in the literature. […] It therefore seems necessary to diagnose and manage people with ME/CFS as early as possible to prevent worsening of symptoms and improve prognosis.
#66 Underdiagnosis of myalgic encephalomyelitis/chronic fatigue syndrome-like illness in a large integrated healthcare system â Kaiser Permanente Northern California, 2022-2023 | medRxiv
https://www.medrxiv.org/content/10.1101/2024.12.04.24318508v1.full-text
ME/CFS is underdiagnosed in the Kaiser Permanente Northern California healthcare system. Enhanced syndromic surveillance that characterizes patients with ME/CFS who have not been diagnosed has the potential to increase timely recognition of ME/CFS. […] In an integrated healthcare system with 2.7 million adult members, an estimated 1.8% had symptoms consistent with ME/CFS-like illness during a two-year period. Of those with ME/CFS-like illness, 97.8% had no documentation of an ME/CFS diagnosis, despite a high level of primary care utilization; 53% of those with ME/CFS-like illness and no EHR diagnosis reported fatigue began less than three years prior. These findings suggest that many people with ME/CFS are not recognized, particularly those with recent onset. Earlier diagnosis of ME/CFS by clinicians might facilitate improvement in outcomes and prevention of disease progression for this group.
#67 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/235980-overview
Certain symptoms may persist or worsen over time. […] Individuals with ME/CFS have a poor prognosis with low rates of recovery or improvement. […] The study revealed that ME/CFS patients have a poor prognosis with low rates of recovery or improvement. It found that older patients with ME/CFS have better outcomes compared to younger patients. […] Diagnostic delays were linked to a poorer prognosis, underscoring the importance of early diagnosis and management. Increased awareness among healthcare providers about ME/CFS is crucial for enhancing patient outcomes.