Data Confirms Long COVID Can Mirror ME/CFS

A major new study from the NIH RECOVER Initiative confirms what patients have reported for years: Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can look remarkably similar. Using electronic health records from 6.5 million adults, researchers developed machine learning models to identify clinical patterns and found that about half of the patients flagged for one condition were also flagged for the other.

Fatigue, shortness of breath (dyspnea), and cognitive impairment were top predictors for both conditions. While cardiopulmonary symptoms were more common in Long COVID, ME/CFS was more often linked with pain, sleep disruption, immune dysfunction, and nutritional deficiencies. These patterns suggest shared biological mechanisms, such as immune dysregulation and mitochondrial dysfunction.

This large-scale, data-driven analysis adds weight to the growing recognition that both conditions may belong to the same family of post-infectious, immune-mediated chronic diseases. It builds on the known history of post-viral illness and expands on Dr. Azola’s reflections about overlapping care needs for patients with Long COVID and ME/CFS.

As public health agencies weigh future research investments, this study strengthens the case for integrated approaches to diagnosis, management, and funding across these deeply intertwined conditions.

Citation

Powers, J. P., et al, & N3C Consortium and RECOVER-EHR (2025). Identifying commonalities and differences between EHR representations of PASC and ME/CFS in the RECOVER EHR cohort. Communications medicine, 5(1), 109. https://doi.org/10.1038/s43856-025-00827-5