Post Exertional Malaise in Long Covid

 Severe exercise-induced myopathy has been found in long COVID post-exertional malaise (PEM).  

Just look at these long COVID patients (in red) pushing close to 20 mmol/L lactate on the exercise bike!  That is serious dedication for a group of patients who know what the consequences will be.

After the exercise test, blood metabolomics show elevated glycolysis, but decreased pyruvate and TCA cycle metabolites.

Muscle biopsy metabolomics show decreased purine synthesis and TCA cycle.

Key:

Appelman, B., Charlton, B.T., Goulding, R.P. et al. Muscle abnormalities worsen after post-exertional malaise in long COVID. Nat Commun 15, 17 (2024). https://doi.org/10.1038/s41467-023-44432-3