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COVID-19 and chronic fatigue syndrome: Is the worst yet to come?
- Source :
- Medical Hypotheses
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- There has been concern about possible long-term sequelae resembling myalgic encephalomyelitis/chronic fatigue syndrome in COVID-19 patients. Clarifying the mechanisms underlying such a "post-COVID-19 fatigue syndrome" is essential for the development of preventive and early treatment methods for this syndrome. In the present paper, by integrating insights pertaining to the glymphatic system and the nasal cerebrospinal fluid outflow pathway with findings in patients with chronic fatigue syndrome, idiopathic intracranial hypertension, and COVID-19, I provide a coherent conceptual framework for understanding the pathophysiology of post-COVID-19 fatigue syndrome. According to this hypothesis, this syndrome may result from damage to olfactory sensory neurons, causing reduced outflow of cerebrospinal fluid through the cribriform plate, and further leading to congestion of the glymphatic system with subsequent toxic build-up within the central nervous system. I further postulate that patients with post-COVID-19 fatigue syndrome may benefit from cerebrospinal fluid drainage by restoring glymphatic transport and waste removal from the brain. Obviously, further research is required to provide further evidence for the presence of this post-viral syndrome, and to provide additional insight regarding the relative contribution of the glymphatic-lymphatic system to it. Other mechanisms may also be involved. If confirmed, the glymphatic-lymphatic system could represent a target in combating post-COVID-19 fatigue syndrome. Moreover, further research in this area could also provide new insights into the understanding of chronic fatigue syndrome.
- Subjects :
- Central Nervous System
0301 basic medicine
medicine.medical_specialty
Time Factors
Pseudotumor cerebri
Models, Neurological
Central nervous system
Cribriform plate
Article
Olfactory Receptor Neurons
03 medical and health sciences
0302 clinical medicine
Cerebrospinal fluid
medicine
Chronic fatigue syndrome
Post-COVID-19 fatigue syndrome
Humans
Intensive care medicine
Pandemics
Pseudotumor Cerebri
Fatigue Syndrome, Chronic
SARS-CoV-2
business.industry
COVID-19
Brain
Ethmoid bone
General Medicine
medicine.disease
Lymphatic system
Idiopathic intracranial hypertension
Ethmoid Bone
030104 developmental biology
medicine.anatomical_structure
Etiology
Glymphatic system
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 03069877
- Volume :
- 146
- Database :
- OpenAIRE
- Journal :
- Medical Hypotheses
- Accession number :
- edsair.doi.dedup.....46e29e03fb844a8287dec4eb235e62fc