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POTS, ME/CFS and Long COVID: Recent Advances and Future Direction

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology & Rheumatology".

Deadline for manuscript submissions: 20 January 2026 | Viewed by 9311

Special Issue Editor


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Guest Editor
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
Interests: autonomic disorders; postural orthostatic tachycardia syndrome; Long COVID; autoimmunity; immunotherapy; women’s health
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Special Issue Information

Dear Colleagues,

Postural orthostatic tachycardia syndrome (POTS), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID are complex syndromes caused by or associated with the dysfunction of the autonomic nervous system, which can follow an acute infection. Disorders of the autonomic nervous system have been an evolving area of research and clinical practice. In the past 5 years, the SARS-CoV-2 pandemic further underscored the need to elucidate the autonomic mechanisms of post-acute infectious syndromes, such as POTS, ME/CFS and long COVID. To this end, understanding the pathophysiology of and developing diagnostic as well as therapeutic approaches for these three syndromes are critical to improving patient care; they also serve as an opportunity to lead to groundbreaking discoveries in all autonomic disorders and post-acute infectious syndromes. In this Special Issue of the Journal of Clinical Medicine, the aim is to collect papers on a variety of topics concerning POTS, ME/CFS and long COVID. Studies and reviews on the potential biomarkers and identification of effective diagnostic tests as well as therapeutic options  in patients with these disorders are of particular interest.

We look forward to receiving your submissions to this Special Issue.

Dr. Svetlana Blitshteyn
Guest Editor

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Keywords

  • POTS
  • ME/CFS
  • long COVID
  • dysautonomia
  • orthostatic intolerance
  • autoimmunity

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Published Papers (2 papers)

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Research

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15 pages, 497 KB  
Article
Autonomic Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Findings from the Multi-Site Clinical Assessment of ME/CFS (MCAM) Study in the USA
by Anindita Issa, Jin-Mann S. Lin, Yang Chen, Jacob Attell, Dana Brimmer, Jeanne Bertolli, Benjamin H. Natelson, Charles W. Lapp, Richard N. Podell, Andreas M. Kogelnik, Nancy G. Klimas, Daniel L. Peterson, Lucinda Bateman and Elizabeth R. Unger
J. Clin. Med. 2025, 14(17), 6269; https://doi.org/10.3390/jcm14176269 - 5 Sep 2025
Viewed by 4946
Abstract
Background/Objectives: Symptoms of autonomic dysfunction are common in infection-associated chronic conditions and illnesses (IACCIs), including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This study aimed to evaluate autonomic symptoms and their impact on ME/CFS illness severity. Methods: Data came from a multi-site study [...] Read more.
Background/Objectives: Symptoms of autonomic dysfunction are common in infection-associated chronic conditions and illnesses (IACCIs), including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This study aimed to evaluate autonomic symptoms and their impact on ME/CFS illness severity. Methods: Data came from a multi-site study conducted in seven ME/CFS specialty clinics during 2012–2020. Autonomic dysfunction was assessed using the Composite Autonomic Symptom Scale 31 (COMPASS-31), medical history, and a lean test originally described by the National Aeronautics and Space Administration (NASA). Illness severity was assessed using Patient-Reported Outcomes Measurement Information System measures, the 36-item short-form, as well as the CDC Symptom Inventory. This analysis included 442 participants who completed the baseline COMPASS-31 assessment, comprising 301 individuals with ME/CFS and 141 healthy controls (HC). Results: ME/CFS participants reported higher autonomic symptom burden than HC across three assessment tools (all p < 0.0001), including the COMPASS-31 total score (34.1 vs. 6.8) and medical history indicators [dizziness or vertigo (42.6% vs. 2.8%), cold extremities (38.6% vs. 5.7%), and orthostatic intolerance (OI, 33.9% vs. 0.7%)]. Among ME/CFS participants, 97% had at least one autonomic symptom. Those with symptoms in the OI, gastrointestinal, and pupillomotor domains had significantly higher illness severity than those without these symptoms. Conclusions: ME/CFS patients exhibit a substantial autonomic symptom burden that correlates with greater illness severity. Individualized care strategies targeting dysautonomia assessment and intervention may offer meaningful improvements in symptom management and quality of life for those with ME/CFS and similar chronic conditions. Full article
(This article belongs to the Special Issue POTS, ME/CFS and Long COVID: Recent Advances and Future Direction)
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7 pages, 404 KB  
Brief Report
A Signal for Voice and Speech Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
by Stephanie L. Grach, Jaime Seltzer and Diana M. Orbelo
J. Clin. Med. 2025, 14(14), 4847; https://doi.org/10.3390/jcm14144847 - 8 Jul 2025
Viewed by 3239
Abstract
Background/Objectives: Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may report abnormalities in voice and speech; however, no formal research has been conducted in this area. Methods: An online mixed-methods survey was completed by 685 people with ME/CFS. A total of 302 [...] Read more.
Background/Objectives: Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may report abnormalities in voice and speech; however, no formal research has been conducted in this area. Methods: An online mixed-methods survey was completed by 685 people with ME/CFS. A total of 302 respondents completed the qualitative component (44.09%). Questions assessed disease experience with ME/CFS and post-exertional malaise without prompting on specific symptoms. Within the qualitative results, a search of the terms “speech, voice,” “words,” and “speak” was conducted. Results: Excluding neurocognitive associations, colloquial phrases, and “speech therapy,” there were 38 mentions of the terms in the context of voice or speech changes across 28 unique qualitative survey responses (9.27%). Conclusions: A notable portion of respondents reported voice or speech changes when responding to open-ended qualitative questions about their disease experience. More research is needed regarding the implications of voice and speech anomalies in ME/CFS pathology and disease monitoring. Full article
(This article belongs to the Special Issue POTS, ME/CFS and Long COVID: Recent Advances and Future Direction)
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