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However, there is increasing evidence that a proportion of COVID-19 patients experience a prolonged convalescence and continue to have symptoms lasting several months after the initial infection. A variety of chronic symptoms have been reported including fatigue, dyspnea, myalgia, exercise intolerance, sleep disturbances, difficulty concentrating, anxiety, fever, headache, malaise, and vertigo. These symptoms are similar to those seen in myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS), a chronic multi-system illness characterized by profound fatigue, sleep disturbances, neurocognitive changes, orthostatic intolerance, and post-exertional malaise. ME\/CFS symptoms are exacerbated by exercise or stress and occur in the absence of any significant clinical or laboratory findings. The pathology of ME\/CFS is not known: it is thought to be multifactorial, resulting from the dysregulation of multiple systems in response to a particular trigger. Although not exclusively considered a post-infectious entity, ME\/CFS has been associated with several infectious agents including Epstein\u2013Barr Virus, Q fever, influenza, and other coronaviruses. There are important similarities between post-acute COVID-19 symptoms and ME\/CFS. However, there is currently insufficient evidence to establish COVID-19 as an infectious trigger for ME\/CFS. Further research is required to determine the natural history of this condition, as well as to define risk factors, prevalence, and possible interventional strategies.<\/jats:p>","DOI":"10.1177\/20499361211009385","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T18:44:33Z","timestamp":1618944273000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":96,"title":["COVID-19 and post-infectious myalgic encephalomyelitis\/chronic fatigue syndrome: a narrative review"],"prefix":"10.1177","volume":"8","author":[{"given":"Sonia","family":"Poenaru","sequence":"first","affiliation":[{"name":"Department of Medicine, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 206, Ottawa, Ontario, K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J.","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Corrales-Medina","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"},{"name":"Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6648-5109","authenticated-orcid":false,"given":"Juthaporn","family":"Cowan","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"},{"name":"Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,4,20]]},"reference":[{"key":"bibr1-20499361211009385","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.19719"},{"key":"bibr2-20499361211009385","volume":"370","author":"Greenhalgh T","year":"2020","journal-title":"BMJ"},{"key":"bibr3-20499361211009385","unstructured":"Garner P. 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