A new study published in Nature Communication by Brent Appelman and colleagues reveals that muscle abnormalities worsen after post-exertional malaise (PEM) in long-Covid patients. PEM is a condition that causes severe fatigue, pain, and cognitive impairment after physical or mental exertion. Long-Covid is a term used to describe the persistent symptoms that some people experience after recovering from Covid-19 infection.
The researchers used magnetic resonance spectroscopy (MRS) to measure the levels of phosphocreatine (PCr), a molecule that stores energy in muscles, in 20 long-Covid patients and 10 healthy controls. They found that long-Covid patients had lower PCr levels than controls at baseline, indicating reduced muscle energy. They also performed a submaximal exercise test on a stationary bike and measured PCr levels again 24 hours later. They found that long-Covid patients had a further decrease in PCr levels after exercise, while controls had no change or a slight increase. This suggests that long-Covid patients have impaired muscle recovery and increased muscle damage after exertion.
The study also assessed the symptoms of PEM using a questionnaire. They found that long-Covid patients reported significantly higher scores of fatigue, pain, and cognitive dysfunction after exercise than before, while controls reported no change or a slight improvement. The researchers also found a correlation between the change in PCr levels and the change in PEM symptoms, indicating that muscle abnormalities may contribute to the severity of PEM.
The study is the first to demonstrate objective evidence of muscle dysfunction in long-Covid patients using MRS. It also provides a potential biomarker for PEM that could be used to diagnose and monitor long-Covid patients. The researchers suggest that future studies should investigate the mechanisms underlying muscle abnormalities in long-Covid and explore potential treatments to improve muscle function and reduce PEM symptoms.
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