In other pieces, doctors and researchers have stated that long COVID is indistinguishable from chronic fatigue syndrome (ME/CFS). One of the hallmarks of both conditions is post-exertional malaise or exhaustion, which is all out of proportion to the amount of exercise the patient has done.
Why long COVID can cause exhaustion, or post-exertional malaise, after exercise
Patients with both conditions are frequently told to exercise “to get back in shape.” Those who haven’t experienced post-exertional malaise seldom show comprehension of the bone-deep fatigue (and often increased pain) following any physical exercise that can last days or even weeks. Patients are frequently accused of malingering.
The idea that exercise can help patients has proven difficult to shake — despite evidence suggesting this isn’t merely a case of deconditioning that patients can overcome by pushing through the pain.
“I don’t think the messaging has been strong enough,” says David Putrino, the director of rehabilitation innovation for Mount Sinai Health System. “It is very clear that this is not a typical response to exercise.”
Now research published this month in Nature Communications gives new weight to this assessment.
By taking biopsies from long COVID patients before and after exercising, scientists in the Netherlands constructed a startling picture of widespread abnormalities in muscle tissue that may explain this severe reaction to physical activity.
Among the most striking findings were clear signs that the cellular power plants, the mitochondria, are compromised and the tissue starved for energy.
“We saw this immediately and it’s very profound,” says Braeden Charlton, one of the study’s authors at Vrije University in Amsterdam.
The tissue samples from long COVID patients also revealed severe muscle damage, a disturbed immune response, and a buildup of microclots.
“This is a very real disease,” says Charlton. “We see this at basically every parameter that we measure.”
You can read the study here: Muscle abnormalities worsen after post-exertional malaise in long COVID