The coronavirus is triggering all sorts of diseases other than ME/CFS – that’s good news for anyone with a post-infectious illness

We thought the coronavirus would trigger a lot of chronic fatigue syndrome (ME/CFS), and it has. The big surprise is what else it’s doing. The coronavirus is turning out to be quite the disease accelerator.

the coronavirus is triggering many different illnesses

How many different diseases will the coronavirus trigger?

It’s giving us our first good look at the whole realm of post-infectious illnesses – and it’s a doozy.

ME/CFS – was expected, postural orthostatic tachycardia syndrome – ditto, some autoimmune diseases – for sure… but dozens of other diseases? (And we don’t have data on many others) … I don’t think anyone counted on that.

Of course, they didn’t. Except for ME/CFS, the field of post-infectious illness hardly existed. Post-infectious illnesses were kind of a poor cousin to more “real illnesses”. The real work – fighting off the infection – that had already been done. If you had problems afterward, well, they weren’t serious enough to warrant the medical field’s attention. They were your problem, not the medical profession. That attitude is changing.

With these large studies underway, we’re starting to see what a viral infection can do and it’s opening eyes. The literature already tells us one thing – that the number of diseases that can be triggered by an infection is going to jump dramatically – and that finding should prompt more studies of what viruses and other pathogens can do to the body. It’s also beginning studies into the long-term effects of other pathogens.

If a mild coronavirus infection can cause long COVID, why not the common cold or the flu or a stomach virus? One recent study found other respiratory infections were just as likely to trigger a neurological or psychiatric disorder as the coronavirus. The implications of that are enormous and let’s hope that the medical field has the guts to take this issue on and see if it’s been missing something important all this time.

The fact that some diseases are being triggered by the coronavirus, while others are not, is going to tell us something about the impact of an infection on the body. The fact that the coronavirus appears particularly adept at triggering ME/CFS is in itself illuminating. Over time, we should learn which parts of the body or systems in the body are particularly vulnerable to the long-term consequences of infections, and why.

The studies that are assessing the rates of post-infectious illnesses tend to be huge and often number in the millions. Check out, below, the astonishingly wide number of disorders a coronavirus infection appears to be triggering.

“Functional Disorders” (ME/CFS, fibromyalgia, irritable bowel syndrome, environmental illness, interstitial cystitis)

Nothing to find here! It’s an odd thing. While many studies have shown that fatigue, pain, sleep, and cognition are impaired in long COVID, and ME/CFS is the disease most associated with it, I couldn’t find any large studies that assessed the incidence of any of the above conditions. That may be because ME/CFS is rarely diagnosed, plus the fact we haven’t seen many big studies looking at the incidence of musculoskeletal or gut disorders, or disorders like ME/CFS. I have been told that information is in some of these databases but  it has apparently not been analyzed.

Moving on…

Gynecological Disorders

Another miss. We know that gynecological disorders are increased in ME/CFS and that women are more likely to have long COVID than men, yet I was unable to find any study assessing the prevalence of gynecological disorders in long COVID.



Autoimmune Disorders

Eric Topol has been way ahead of the game in long COVID and he recently penned a fascinating article, “The heightened risk of autoimmune diseases after Covid“.

Topol’s review of autoimmune diseases that occur after a coronavirus infection shows how quickly the field is moving. As of January of this year, Topol didn’t feel he could say anything concrete about autoimmunity and long COVID, but by May, three large studies – following millions of people (thanks to electronic health records) had been published.

Topol wrote that coming down with a COVID infection results in a “substantially increased risk of developing a diverse spectrum of new-onset autoimmune diseases.” The increased risk –  20-40% – is not small at all, and diverse is an understatement. The number of autoimmune diseases that fall into this category is astounding, and I would bet my bottom dollar that it’s going to rise dramatically over time as the patients are followed for longer periods of time. (Two of the studies followed COVID-19 patients for a year, while the other followed many of its patients for less than a year.) They include:

  • rheumatoid arthritis (aHR:2.98, 95% CI:2.78–3.20),
  • ankylosing spondylitis (aHR:3.21, 95% CI:2.50–4.13),
  • systemic lupus erythematosus (aHR:2.99, 95% CI:2.68–3.34),
  • dermatopolymyositis (aHR:1.96, 95% CI:1.47–2.61),
  • systemic sclerosis (aHR:2.58, 95% CI:2.02–3.28),
  • Sjögren’s syndrome (aHR:2.62, 95% CI:2.29–3.00),
  • mixed connective tissue disease (aHR:3.14, 95% CI:2.26–4.36),
  • Behçet’s disease (aHR:2.32, 95% CI:1.38–3.89),
  • polymyalgia rheumatica (aHR:2.90, 95% CI:2.36–3.57),
  • vasculitis (aHR:1.96, 95% CI:1.74–2.20),
  • psoriasis (aHR:2.91, 95% CI:2.67–3.17),
  • inflammatory bowel disease (aHR:1.78, 95%CI:1.72–1.84),
  • celiac disease (aHR:2.68, 95% CI:2.51–2.85),
  • type 1 diabetes mellitus

Understanding which autoimmune diseases get triggered the most might help us understand the pathology behind the most commonly triggered post-SARS-CoV-2 illness – ME/CFS. Note that mixed connective tissue disease is one of the most commonly triggered autoimmune diseases and that Sjogren’s Syndrome – a common diagnosis in postural orthostatic tachycardia syndrome (POTS) – is up there as well.

The red line apparently indicates no increase in diagnoses in COVID-19 patients vs non-COVID-19 patients.

It was interesting to see that the diagnosis of celiac disease (the autoimmune reaction to wheat which, among other things, causes malabsorption of nutrients) – commonly thought of a genetic disorder – was increased.

The one autoimmune disease we might have expected to be in there – multiple sclerosis (MS) – is not. Since we know EBV plays a big role in MS, and we know EBV reactivation is common in long COVID, one would have thought MS would have popped up. Studies assessing the incidence of MS after infectious mononucleosis (EBV) find that it takes quite some time, though, for MS to show up.

While some recent studies have not found evidence of increased levels of autoantibodies, others have, and Topol pointed a finger at the high levels of autoantibodies focused on the herpes viruses such as the Epstein-Barr virus (EBV) that Iwasaki found. Interestingly, Topol also pointed out that, while such cases appear to be very rare, that COVID vaccines may be triggering some autoimmune conditions (rheumatoid arthritis, Type 1 diabetes, systemic lupus erythematosus (SLE), and autoimmune polyarthritis) as well.

Neurological Diseases

Neurological symptoms stood out in long COVID from the beginning and, of course, are common in ME/CFS, fibromyalgia, and POTS as well. It’s clear that both the central nervous and peripheral nervous systems are involved. It’s not surprising, then, to see that quite a few large studies have assessed the prevalence of post-infectious neurological diseases. Quite a few neurological disorders popped up, including some you might not have thought would be associated with infection such as psychosis. (Health Rising has a blog coming up on psychosis and ME/CFS).

One study, interestingly, found that the incidence of neurological disorders jumped up dramatically in the first six months after the infection and then declined, leaving only four (including psychotic disorders) still increased after two years.

One 3.8 million-person study found an increased incidence of:

  • anxiety disorder;
  • mood disorder;
  • psychotic disorder;
  • insomnia;
  • cognitive deficit;
  • dementia;
  • epilepsy or seizures;
  • encephalitis;
  • intracranial haemorrhage;
  • ischaemic stroke;
  • parkinsonism;
  • Guillain-Barré syndrome;
  • nerve, nerve root, and plexus disorders;
  • myoneural junction (neuromuscular) and muscle disease.


  • The field of post-infectious diseases didn’t (except for ME/CFS) exist prior to the coronavirus. The medical field focused on treating infections – not dealing with their aftermath. Recent studies indicate why that’s not going to fly anymore – and it’s not just because of ME/CFS. It’s because large studies are indicating that a coronavirus infection – whether it’s mild or severe – is upping the risk for all sorts of diseases.
  • Most of these studies are very large – running into the millions of participants – that rely on electronic health records. They’re comparing the incidence of new diagnoses in people who were infected with the coronavirus with those who weren’t.
  • Eric Topol recently wrote a blog on the autoimmune implications of COVID-19. Three recently published large studies lead Topol to report a “substantially increased risk of developing a diverse spectrum of new-onset autoimmune diseases.
  • The increased risk was not low – a 20-40% increase in the likelihood of coming down with one of these illnesses – and the range of autoimmune illnesses affected was diverse indeed: the studies pointed to dramatic increases in the diagnosis of almost 20 autoimmune diseases. (See blog for the diseases). Since autoimmune disease can take a while to show up after an infection, one can only assume that this number will rise over time.
  • Other studies have found a marked increase in neurological diseases, including some one might not have thought. Besides things like cognitive disorders, sharp increases in the rates of psychotic disorders, epilepsy, stroke, and parkinsonism as well as others.
  • Cardiovascular and metabolic diseases have not been as well assessed but increases in asthma, type I and type II diabetes, respiratory diseases, heart failure, and stroke have been seen.
  • Oddly enough, none of these studies have assessed increased incidences of the one disease long COVID has been most associated with – ME/CFS. Nor have they assessed new diagnoses of fibromyalgia, IBS, dysautonomia, postural orthostatic tachycardia syndrome (POTS), or gynecological diseases.
  • If you want more research into post-infectious illnesses, then linking an infectious event to dozens of serious illnesses can only help.
  • The study makes one wonder how many chronic illnesses were triggered by an infectious event.
  • For all of its horrendous impact, the coronavirus pandemic is clearly going to force the medical profession to take a very close look at what happens during an infectious event – and afterward – and that is good news for anyone with a post-infectious illness like ME/CFS.
A ten million-person-plus Veterans Administration study found an increased risk of:

  • cognition and memory disorders;
  • peripheral nervous system disorders;
  • episodic disorders (for example, migraine and seizures);
  • extrapyramidal and movement disorders;
  • mental health disorders;
  • musculoskeletal disorders;
  • sensory disorders;
  • Guillain-Barré syndrome;
  • encephalitis or encephalopathy.

A study following a million and a half people found increased rates of the following diseases six months after the infection:

  • anxiety disorder;
  • mood disorder;
  • psychotic disorder;
  • Insomnia;
  • cognitive deficit;
  • dementia;
  • epilepsy or seizures;
  • ischaemic stroke;
  • intracranial haemorrhage;
  • myoneural junction or muscle disease.

Two years after an infection, the following risks remained elevated:

  • cognitive deficit;
  • dementia;
  • psychotic disorders;
  • epilepsy or seizures.

Cardiovascular / Cardiopulmonary

Surprisingly, given the effects of COVID-19 on the blood vessels and the lungs, the rates of post-infectious cardiovascular/cardiopulmonary disorders have not been as well assessed, but various studies have found an increased risk of asthma, respiratory diseases, heart failure, and ischemic and hemorrhagic stroke.

Good News


The medical community is surely giving pathogens another look.

ME/CFS and POTS are in good company. The fact that a coronavirus infection is able to trigger so many major autoimmune and neurological diseases is good news for anyone who wants to get to the bottom of how infections trigger chronic illnesses. If you want more research into post-infectious illnesses, then linking an infectious event to dozens of serious illnesses is a darn good way to start.

Given these figures, one wonders how many chronic illnesses are actually post-infectious illnesses. The idea that infections could have manifest results, including the production of many chronic diseases, showed up in the early 1900s in “focal infection theory“. By the 1920s, it had apparently become widely accepted in medical circles but was largely discredited by the 1960s.

Other germ theories of chronic illness have been proposed but don’t seem to have received much attention – but my guess is that these long-COVID studies are going to change that. Post-infectious illnesses have existed in a kind of dark area in medicine. While much effort has been focused on defeating infections, despite statistics that maybe 5% of people with an infection have a difficult time recovering, they’ve been almost totally ignored – until now.

Look at what’s happened with post-treatment Lyme disease syndrome (PTLDS). Here we have a very clear connection between a single pathogen and a chronic illness, yet despite the fact that many people come down with Lyme disease, until recently, both PTLDS research and Lyme research were woefully underfunded. (Congressional action and a strategic plan changed that.) I was told years ago that researchers in the U.S. just aren’t interested in pathogens. That is surely changing…



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