Published: 07-09-2023 09:51 | Updated: 07-09-2023 10:37

Connection between metabolism and fatigue after Crimean-Congo Fever

Hyalomma tick
Hyalomma tick Photo: Getty Images

Crimean-Congo Haemorrhagic Fever Virus (CCHF) spreads via ticks and is on the World Health Organization’s (WHO) list of priority diseases, with a high case fatality rate and no or insufficient countermeasures. A recent study published by researchers from Karolinska Institutet in collaboration with Sivas Cumhuriyet University, Turkey, sheds light on the connection between Crimean-Congo Haemorrhagic Fever Virus (CCHFV) infection and prolonged fatigue.

The study examining the acute stages of Crimean-Congo hemorrhagic fever (CCHFV) infections has revealed a crucial link between the virus, metabolic imbalance, and the debilitating exhaustion that afflicts some individuals long after their recovery.

Ujjwal Neogi
Ujjwal Neogi. Photo: Stefan Zimmerman

– Our study not only offered insights into the progression of the CCHFV infection itself but also unveiled the intricate relationship between the virus and our body's energy and carbon metabolism, Ujjwal Neogi explains, senior author and virologist at the Department of Laboratory Medicine.

The research, led by a team of experts in virology and computational biology, aimed to shed light on the underlying mechanisms contributing to the prolonged fatigue experienced by a subset of patients who have battled viral illnesses. The findings, published in the prestigious Proceedings of the National Academy of Sciences (PNAS), USA, could pave the way for improved treatments and support for those grappling with the aftermath of viral infections.r.

By investigating the genetic activity of blood samples collected from CCHFV patients at various stages of their illness, the scientists could discern significant metabolic fluctuations during the active phases of infection.

Prof. Nazif Elaldi from Sivas Cumhuriyet University, Turkey is the chief Physician Scientist in the study and explains further.

– The exhaustion that follows viral infections has long puzzled medical professionals. Our research indicates that the disruption in metabolism caused by CCHFV infection could be a driving force behind the development of post-viral fatigue syndrome. 

Hopes of better quality of life

Photo of researcher Anoop Ambikan
Anoop Ambikan. Photo: Christina Sundqvist

The significance of these findings extends beyond CCHFV. The study lays the groundwork for a more comprehensive understanding of post-viral fatigue syndrome across various viral illnesses by unraveling the intricate link between viral infection and metabolic changes. This newfound knowledge could lead to the development of tailored interventions and treatments to address the lingering fatigue that impedes the quality of life for countless individuals.

Dr. Anoop Ambikan, a computational biologist involved in the study, emphasized the holistic approach taken in the research.

– We created comprehensive models that allowed us to track the metabolic changes at different stages of the infection – from acute onset to early recovery and even post-recovery. This multi-dimensional analysis provided invaluable insights into the progression of the disease and the body's responses. 

As the study primarily focused on patients with non-severe CCHFV infections, the research team acknowledges the need to expand their investigations to include a broader spectrum of severe cases

– Our study had limitations due to the high mortality rate among severe patients. We intend to recruit a larger sample size, including those who have survived severe disease, to refine our understanding of recovery processes further, Dr. Neogi revealed.

The study was funded by the Swedish Research Council, Sivas Cumhuriyet University Rectorate Scientific Research Projects (CUBAP), and European Union Horizon2020 grants.


"Systems-level temporal immune-metabolic profile in Crimean-Congo hemorrhagic fever virus infection", Ambikan AT, Elaldi N, Svensson-Akusjärvi S, Bagci B, Pektas AN, Hewson R, Bagci G, Arasli M, Appelberg S, Mardinoglu A, Sood V, Végvári Á, Benfeitas R, Gupta S, Cetin I, Mirazimi A, Neogi U, PNAS, online 5 september 2023.