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Muscle abnormalities worsen after post-exertional malaise in long COVID

Author

Listed:
  • Brent Appelman

    (Center for Experimental and Molecular Medicine
    Infectious diseases)

  • Braeden T. Charlton

    (Vrije Universiteit Amsterdam
    Amsterdam Movement Sciences)

  • Richie P. Goulding

    (Vrije Universiteit Amsterdam
    Amsterdam Movement Sciences)

  • Tom J. Kerkhoff

    (Vrije Universiteit Amsterdam
    Amsterdam Movement Sciences
    Amsterdam UMC location Vrije Universiteit Amsterdam
    Amsterdam Cardiovascular Sciences)

  • Ellen A. Breedveld

    (Vrije Universiteit Amsterdam
    Amsterdam Movement Sciences)

  • Wendy Noort

    (Vrije Universiteit Amsterdam
    Amsterdam Movement Sciences)

  • Carla Offringa

    (Vrije Universiteit Amsterdam
    Amsterdam Movement Sciences)

  • Frank W. Bloemers

    (Amsterdam Movement Sciences
    Amsterdam UMC location University of Amsterdam)

  • Michel Weeghel

    (Amsterdam UMC location University of Amsterdam)

  • Bauke V. Schomakers

    (Amsterdam UMC location University of Amsterdam)

  • Pedro Coelho

    (Hospital de Santa Maria, CHULN
    University of Lisbon
    Amsterdam UMC location University of Amsterdam)

  • Jelle J. Posthuma

    (Amsterdam UMC location University of Amsterdam
    Flevoziekenhuis, Division of Surgery)

  • Eleonora Aronica

    (Amsterdam UMC location University of Amsterdam)

  • W. Joost Wiersinga

    (Center for Experimental and Molecular Medicine
    Infectious diseases
    Amsterdam UMC location University of Amsterdam)

  • Michèle Vugt

    (Infectious diseases
    Amsterdam UMC location University of Amsterdam)

  • Rob C. I. Wüst

    (Vrije Universiteit Amsterdam
    Amsterdam Movement Sciences)

Abstract

A subgroup of patients infected with SARS-CoV-2 remain symptomatic over three months after infection. A distinctive symptom of patients with long COVID is post-exertional malaise, which is associated with a worsening of fatigue- and pain-related symptoms after acute mental or physical exercise, but its underlying pathophysiology is unclear. With this longitudinal case-control study (NCT05225688), we provide new insights into the pathophysiology of post-exertional malaise in patients with long COVID. We show that skeletal muscle structure is associated with a lower exercise capacity in patients, and local and systemic metabolic disturbances, severe exercise-induced myopathy and tissue infiltration of amyloid-containing deposits in skeletal muscles of patients with long COVID worsen after induction of post-exertional malaise. This study highlights novel pathways that help to understand the pathophysiology of post-exertional malaise in patients suffering from long COVID and other post-infectious diseases.

Suggested Citation

  • Brent Appelman & Braeden T. Charlton & Richie P. Goulding & Tom J. Kerkhoff & Ellen A. Breedveld & Wendy Noort & Carla Offringa & Frank W. Bloemers & Michel Weeghel & Bauke V. Schomakers & Pedro Coelh, 2024. "Muscle abnormalities worsen after post-exertional malaise in long COVID," Nature Communications, Nature, vol. 15(1), pages 1-15, December.
  • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-023-44432-3
    DOI: 10.1038/s41467-023-44432-3
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    References listed on IDEAS

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    1. Eric Y. Wang & Tianyang Mao & Jon Klein & Yile Dai & John D. Huck & Jillian R. Jaycox & Feimei Liu & Ting Zhou & Benjamin Israelow & Patrick Wong & Andreas Coppi & Carolina Lucas & Julio Silva & Ji Eu, 2021. "Diverse functional autoantibodies in patients with COVID-19," Nature, Nature, vol. 595(7866), pages 283-288, July.
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