Into the looking glass: Post-viral syndrome post COVID-19

We are writing to highlight the potential for a post-viral syndrome to manifest following COVID-19 infection as previously reported following Severe Acute Respiratory Syndrome (SARS) infection, also a coronavirus. After the acute SARS episode some patients, many of whom were healthcare workers went on to develop a Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME) - like illness which nearly 20 months on prevented them returning to work. We propose that once an acute COVID-19 infection has been overcome, a subgroup of remitted patients are likely to experience long-term adverse effects resembling CFS/ME symptomatology such as persistent fatigue, diffuse myalgia, depressive symptoms, and non-restorative sleep. In a contracted future economy, managing likely Post COVID-19 syndrome cases, in addition to existing CFS/ME cases will put additional burden on our already hard pressed healthcare system. We suggest that priority is given to exploration of pragmatic relatively low cost techniques to treat post-viral fatigue, to alleviate symptoms and improve quality of life for those affected by the longer term sequelae of COVID-19.