Skeletal muscle adaptations and post-exertional malaise in long COVID

Braeden T Charlton; Richie P Goulding; Richard T Jaspers; Brent Appelman; Michèle van Vugt; Rob C I Wüst

doi:10.1016/j.tem.2024.11.008

Skeletal muscle adaptations and post-exertional malaise in long COVID

Braeden T Charlton, Richie P Goulding, Richard T Jaspers, Brent Appelman, Michèle van Vugt, Rob C I Wüst

Research output: Contribution to Journal › Comment / Letter to the editor › Academic

Abstract

When acute SARS-CoV-2 infections cause symptoms that persist longer than 3 months, this condition is termed long COVID. Symptoms experienced by patients often include myalgia, fatigue, brain fog, cognitive impairments, and post-exertional malaise (PEM), which is the worsening of symptoms following mental or physical exertion. There is little consensus on the pathophysiology of exercise-induced PEM and skeletal-muscle-related symptoms. In this opinion article we highlight intrinsic mitochondrial dysfunction, endothelial abnormalities, and a muscle fiber type shift towards a more glycolytic phenotype as main contributors to the reduced exercise capacity in long COVID. The mechanistic trigger for physical exercise to induce PEM is unknown, but rapid skeletal muscle tissue damage and intramuscular infiltration of immune cells contribute to PEM-related symptoms.

Original language	English
Journal	Trends in Endocrinology and Metabolism
Early online date	17 Dec 2024
DOIs	https://doi.org/10.1016/j.tem.2024.11.008
Publication status	E-pub ahead of print - 17 Dec 2024

Bibliographical note

Funding

This study was supported the Patient-Led Research Collaborative for Long COVID, ZonMw Onderzoeksprogramma ME/CVS, the Solve ME 2022 Ramsay Grant Program, ME Research UK, ME Stars of Tomorrow Scholarship award from the ICanCME Research Network (to B.T.C.), and Stichting Long COVID Nederland. The authors want to thank our patient representatives for insightful discussions. The authors declare no conflicts of interest.

Funders	Funder number
Center for Visual Science, University of Rochester
ME Research UK
ZonMw Onderzoeksprogramma ME
Patient-Led Research Collaborative for Long COVID
ICanCME Research Network
Stichting Long COVID

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title = "Skeletal muscle adaptations and post-exertional malaise in long COVID",

abstract = "When acute SARS-CoV-2 infections cause symptoms that persist longer than 3 months, this condition is termed long COVID. Symptoms experienced by patients often include myalgia, fatigue, brain fog, cognitive impairments, and post-exertional malaise (PEM), which is the worsening of symptoms following mental or physical exertion. There is little consensus on the pathophysiology of exercise-induced PEM and skeletal-muscle-related symptoms. In this opinion article we highlight intrinsic mitochondrial dysfunction, endothelial abnormalities, and a muscle fiber type shift towards a more glycolytic phenotype as main contributors to the reduced exercise capacity in long COVID. The mechanistic trigger for physical exercise to induce PEM is unknown, but rapid skeletal muscle tissue damage and intramuscular infiltration of immune cells contribute to PEM-related symptoms.",

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AU - Charlton, Braeden T

AU - Goulding, Richie P

AU - Jaspers, Richard T

AU - Appelman, Brent

AU - van Vugt, Michèle

AU - Wüst, Rob C I

PY - 2024/12/17

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N2 - When acute SARS-CoV-2 infections cause symptoms that persist longer than 3 months, this condition is termed long COVID. Symptoms experienced by patients often include myalgia, fatigue, brain fog, cognitive impairments, and post-exertional malaise (PEM), which is the worsening of symptoms following mental or physical exertion. There is little consensus on the pathophysiology of exercise-induced PEM and skeletal-muscle-related symptoms. In this opinion article we highlight intrinsic mitochondrial dysfunction, endothelial abnormalities, and a muscle fiber type shift towards a more glycolytic phenotype as main contributors to the reduced exercise capacity in long COVID. The mechanistic trigger for physical exercise to induce PEM is unknown, but rapid skeletal muscle tissue damage and intramuscular infiltration of immune cells contribute to PEM-related symptoms.

AB - When acute SARS-CoV-2 infections cause symptoms that persist longer than 3 months, this condition is termed long COVID. Symptoms experienced by patients often include myalgia, fatigue, brain fog, cognitive impairments, and post-exertional malaise (PEM), which is the worsening of symptoms following mental or physical exertion. There is little consensus on the pathophysiology of exercise-induced PEM and skeletal-muscle-related symptoms. In this opinion article we highlight intrinsic mitochondrial dysfunction, endothelial abnormalities, and a muscle fiber type shift towards a more glycolytic phenotype as main contributors to the reduced exercise capacity in long COVID. The mechanistic trigger for physical exercise to induce PEM is unknown, but rapid skeletal muscle tissue damage and intramuscular infiltration of immune cells contribute to PEM-related symptoms.

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DO - 10.1016/j.tem.2024.11.008

M3 - Comment / Letter to the editor

C2 - 39694730

SN - 1043-2760

JO - Trends in Endocrinology and Metabolism

JF - Trends in Endocrinology and Metabolism

ER -

Skeletal muscle adaptations and post-exertional malaise in long COVID

Abstract

Bibliographical note

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