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====<span id="catchingcovid19">Risk of COVID-19 in patients with ME/CFS</span>==== There is a lack of evidence about ME/CFS patients developing COVID-19 illness; but a number of medical advisors have given their expert opinions on this. Immunologist and [[Myalgic encephalomyelitis|ME]] researcher Dr [[Nancy Klimas]] has said she believes people with ME/CFS are at a little higher risk of developing COVID-19 after exposure to the virus;<ref name="Klimas20200313">{{Cite web | url = https://www.youtube.com/watch?v=pkGXiJ1jM14 | title = COVID-19 and ME/CFS - Dr Nancy Klimas, Mar 13, 2020 | last = Klimas | first = Nancy | date = 2020-03-13|work=|access-date=Mar 24, 2020| archive-url = | archive-date = |url-status = | quote= | author-link = Nancy Klimas}}</ref> Dr [[Nigel Speight]], Dr [[William Weir]] and Dr [[Charles Shepherd]] have said they do not think there is an increased risk.<ref name="SpeightWeirMar20" /><ref name="SpeightMar20" /><ref name="MEA16Mar20" /> Dr [[Lucinda Bateman]] has said this is unknown.<ref name="Bateman20200323QA">{{Cite web | title = COVID-19 and ME/CFS/FM Frequently Asked Questions | last = Bateman | first = Lucinda | author-link = Lucinda Bateman | website = Bateman-Horne Center | date = 2020-03-23 | url = http://www.batemanhornecenter.org/wp-content/uploads/2020/03/COVID-19-FAQ-Public.pdf}}</ref>Klimas, Speight, Weir, Shepherd and Bateman have all advised ME/CFS patients to take additional precautions, and highlighted that there is a risk of ME/CFS becoming significantly worse after viral infections or after COVID-19.<ref name="Klimas20200313" /><ref name="SpeightWeirMar20" /><ref name="SpeightMar20" /><ref name="MEA16Mar20" /><ref name="Bateman20200323QA" /> ME/CFS includes [[:Category:Immune signs and symptoms|immune symptoms]] including a [[sore throat]], [[swollen lymph nodes]], and [[flu-like symptoms]], but patients are generally '''''not''''' considered to be severely immunocompromised, and immunosuppressant medications are unlikely to be used by most ME/CFS patients. <ref name="Klimas20200313" /> <ref name="canadianconsensus">{{Citation | last1 = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | author-link2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | author-link3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | author-link4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 =Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref><ref name="ICP2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | author-link2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | author-link20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | author-link21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | author-link22 = John McLaren-Howard | last23 = Mena | first23 = I | author-link23 = Ismael Mena | last24 = Miwa | first24 = K | author-link24 = Kunihisa Miwa | last25 = Murovska | first25 = M | author-link25= Modra Murovska | last26 = Stevens | first26 = SR | author-link26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref> A study in 2013 assessed immune system responses to the flu [[vaccine]] in people with ME/CFS, and found them similar to the immune responses of healthy controls, which indicated that vaccine effectiveness was similar in ME/CFS patients, although the study did not include a long-term follow-up to assess duration of vaccine effectiveness or overall effect on ME/CFS symptoms.<ref>{{Cite journal | last = Prinsen | first = Hetty | author-link = | last2 = de Vries | first2 = I. Jolanda M. | author-link2 = | last3 = Torensma | first3 = Ruurd | author-link3 = | last4 = Pots | first4 = Jeanette M. | author-link4 = | last5 = Mulder | first5 = Sasja F. | author-link5 = | last6 = van Herpen | first6 = Carla M. L. | author-link6 = | last7 = Elving | first7 = Lammy D. | last8 = Bleijenberg | first8 = Gijs | author-link8 = Gijs Bleijenberg | last9 = Stelma | first9 = Foekje F. | date = 2012-12-17 | title = Humoral and cellular immune responses after influenza vaccination in patients with chronic fatigue syndrome | url =https://doi.org/10.1186/1471-2172-13-71 | journal = BMC Immunology | volume = 13 | issue = 1 | pages = 71|doi=10.1186/1471-2172-13-71|issn=1471-2172|pmc = 3534525|pmid=23244635|access-date=|quote=|via=}}</ref> This means most ME/CFS patients would '''''not''''' be considered to be at very high risk of COVID-19 illness.<ref name="Klimas20200313" /> The unproven [[autoimmune hypothesis]] states that a subtype of ME involves autoimmunity, which is an overactive immune system rather than a weakened immune response.<ref name="OMF2018research">{{Cite web | url = https://www.omf.ngo/2018/02/28/omf-funded-research-t-cells-molecular-immunology/ | title = OMF-funded research: T cells and molecular immunology | last = Open Medicine Foundation | first = | author-link = Open Medicine Foundation | date = Feb 28, 2018 | website = Open Medicine Foundation|language=en-US|archive-url=|archive-date=|url-status= | access-date = 2019-07-11}}</ref> Evidence for this theory is limited.
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