Taking ME/CFS and Long Covid seriously

Georg Psota, Psychiatrist and Chief Physician of the Psychosocial Service of the City of Vienna, calls for more attention and research into Long/Post-Covid or ME/CFS. In the APA discussion, he emphasized the need to take these diseases seriously and recognize the physiological (physical) cause. He was “disappointed” with the outcome of a consensus conference on the topic held by the Austrian Society for Neurology (ÖGN) a week ago on Friday.

Referring to the meeting on ME/CFS or “post-viral stage pictures”, ÖGN did not adequately recognize “how many people are actually seriously affected”. Psychiatry and neurology specifically criticized the ÖGN representatives for not clearly pointing out the physiological cause of ME/CFS and long or post-Covid after the conference. The company does not dare to openly say that “all patients have nothing”. But in no case are they saying there are serious, complex syndromes where something needs to be done” — and that's “really disappointing.” Chota said this approach is not consistent with international standards.

He expects the ÖGN to “seriously solve neurological problems – they are really difficult problems”. “A virus that invades the brain causes neurological problems: Where's the potential for surprise?” “I really expect every specialist society in Austria to take a scientific stance when it comes to excess mortality.” He also pointed out that fainting is on the rise: it always happens “when people suffer direct brain or organ damage.”

Attribution to psychological causes is incorrect

Attribution of illnesses to psychological causes is wrong, Psota stressed. Because a clear distinction can be made – especially from a mental health perspective – between mental illnesses like depression and the (sometimes severe) fatigue post-Covid or ME/CFS. At last weekend's conference, individual participants emphasized that there was a “very clear consensus” that “it is definitely a physical illness,” as ÖVP health spokesman Josef Smoll said after the meeting. At the same time, ÖGN former president Thomas Berger pointed out that from the perspective of neuroimmunology it is clear that “there is no scientific evidence” that ME/CFS is a true neurological disease. ÖGN emphasized that psychological comorbidities may also be seen in long-covid syndrome.

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However, for Chota, such post-viral conditions must be clearly distinguished from mental illnesses. He criticized some areas of medicine for repeatedly using the lack of clear biomarkers as evidence that it is not a somatic (physical) disease. Psychiatry lacks biomarkers, but diseases are certainly recognized, he made a comparison.

In addition to this, there are indeed markers that indicate the presence of long/post-covid or ME/CFS, Psota pointed to the (easy) possibility of measuring orthostatic problems such as POTS, in which the pulse rate increases abnormally while sitting. He also emphasized that common symptoms such as intolerance to light, noise or smell can be clearly identified.

PEM can be clearly distinguished from depression

PEM (Post Exertional Malaise), a severe stress-relief disorder that occurs in the context of post-Covid or ME/CFS, can be easily distinguished from depression: movement is reduced in depression, while in PEM it is stronger, says Psota. . Sufferers often go beyond their personal stress thresholds, which often results in a significant deterioration in their condition within days due to normal stress.

The psychosis is quite different from ME/CFS, as are somatoform disorders. Problems with psychological processing can arise, for example, if a person faints from seeing blood or has a fear of needles – or if they have severe hypochondria. POTS-like phenomena can be seen in people who are trained and who are experiencing such problems for the first time in their lives – for example as a result of Covid. “It's a disciplinary disorder. It's unbelievable how anyone could get the idea that it's psychosomatic.”

PEM is now recognized worldwide, but not in Austria. “It won't last,” Chota said. “I believe this is not the last round, and if the pressure continues in the political dimension, something will come out of it,” Psota said, hoping for more consensus meetings.

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In an APA interview, Psota lashed out at anyone who denigrates the vaccine or even doubts achievements like the polio vaccine (against polio), German doctor and critic of Covid measures Sucharit Bhakti did on April 12 at an FPÖ event. Vienna (“There is no evidence of its effectiveness”). FPÖ leader Herbert Gigl hailed Bakhti as “a beacon of freedom and health for billions of people”. “How irrational are we?” He said that without speaking directly to the concerned people.

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