Muscle abnormalities worsen after post-exertional malaise in long COVID

Brent Appelman; Braeden T Charlton; Richie P Goulding; Tom J Kerkhoff; Ellen A Breedveld; Wendy Noort; Carla Offringa; Frank W Bloemers; Michel van Weeghel; Bauke V Schomakers; Pedro Coelho; Jelle J Posthuma; Eleonora Aronica; W Joost Wiersinga; Michèle van Vugt; Rob C I Wüst

doi:https://doi.org/10.1038/s41467-023-44432-3

Muscle abnormalities worsen after post-exertional malaise in long COVID

Brent Appelman, Braeden T Charlton, Richie P Goulding, Tom J Kerkhoff, Ellen A Breedveld, Wendy Noort, Carla Offringa, Frank W Bloemers, Michel van Weeghel, Bauke V Schomakers, Pedro Coelho, Jelle J Posthuma, Eleonora Aronica, W Joost Wiersinga, Michèle van Vugt, Rob C I Wüst

Research output: Contribution to journal › Article › Academic › peer-review

24 Citations (Scopus)

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.

Original language	English
Article number	17
Pages (from-to)	17
Journal	Nature communications
Volume	15
Issue number	1
DOIs	https://doi.org/10.1038/s41467-023-44432-3
Publication status	Published - 4 Jan 2024

Keywords

COVID-19/complications
Case-Control Studies
Fatigue/etiology
Humans
Muscle, Skeletal
Musculoskeletal Abnormalities
Pain
Plaque, Amyloid
Post-Acute COVID-19 Syndrome
SARS-CoV-2

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Appelman, B., Charlton, B. T., Goulding, R. P., Kerkhoff, T. J., Breedveld, E. A., Noort, W., Offringa, C., Bloemers, F. W., van Weeghel, M., Schomakers, B. V., Coelho, P., Posthuma, J. J., Aronica, E., Joost Wiersinga, W., van Vugt, M., & Wüst, R. C. I. (2024). Muscle abnormalities worsen after post-exertional malaise in long COVID. Nature communications, 15(1), 17. Article 17. https://doi.org/10.1038/s41467-023-44432-3

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title = "Muscle abnormalities worsen after post-exertional malaise in long COVID",

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.",

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Appelman, B, Charlton, BT, Goulding, RP, Kerkhoff, TJ, Breedveld, EA, Noort, W, Offringa, C, Bloemers, FW , van Weeghel, M , Schomakers, BV, Coelho, P, Posthuma, JJ , Aronica, E , Joost Wiersinga, W , van Vugt, M & Wüst, RCI 2024, 'Muscle abnormalities worsen after post-exertional malaise in long COVID', Nature communications, vol. 15, no. 1, 17, pp. 17. https://doi.org/10.1038/s41467-023-44432-3

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T1 - Muscle abnormalities worsen after post-exertional malaise in long COVID

AU - Appelman, Brent

AU - Charlton, Braeden T

AU - Goulding, Richie P

AU - Kerkhoff, Tom J

AU - Breedveld, Ellen A

AU - Noort, Wendy

AU - Offringa, Carla

AU - Bloemers, Frank W

AU - van Weeghel, Michel

AU - Schomakers, Bauke V

AU - Coelho, Pedro

AU - Posthuma, Jelle J

AU - Aronica, Eleonora

AU - Joost Wiersinga, W

AU - van Vugt, Michèle

AU - Wüst, Rob C I

PY - 2024/1/4

Y1 - 2024/1/4

N2 - 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.

AB - 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.

KW - COVID-19/complications

KW - Case-Control Studies

KW - Fatigue/etiology

KW - Humans

KW - Muscle, Skeletal

KW - Musculoskeletal Abnormalities

KW - Pain

KW - Plaque, Amyloid

KW - Post-Acute COVID-19 Syndrome

KW - SARS-CoV-2

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U2 - https://doi.org/10.1038/s41467-023-44432-3

DO - https://doi.org/10.1038/s41467-023-44432-3

M3 - Article

C2 - 38177128

SN - 2041-1723

VL - 15

SP - 17

JO - Nature communications

JF - Nature communications

IS - 1

M1 - 17

ER -

Muscle abnormalities worsen after post-exertional malaise in long COVID

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Keywords

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