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In addition, we also discovered that ME/CFS is characterized by increased immunoglobulin A/immunoglobulin M (IgA/IgM) responses to Gram-negative bacteria indicating increased bacterial or lipopolysaccharide (LPS) translocation and IgM-mediated autoimmune responses to a number of neoantigens including malondialdehyde (MDA), azelaic acid, and nitrosylated proteins, indicating increased nitrosylation ( TABLE 1 The key adverse outcome pathways (AOPs) of the chronic fatigue spectrum disorders (CFAS-Ds), including those that are secondary to medical disorders such as coronavirus disease 2019 (COVID-19), chronic kidney disease, rheumatoid arthritis, schizophrenia, and major depression

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