researchers Amsterdam University Medical Center We have made important discoveries regarding the persistent fatigue experienced by patients with long-term coronavirus infections.
Experts have identified a biological cause for this debilitating condition. It is a decrease in energy production by mitochondria in muscle cells.
research focus
Study participants, including 25 patients with long-term COVID-19 infection and 21 healthy controls, underwent a 15-minute cycling test.
The test found that the symptoms known as post-exertional malaise (PEM) worsened over time in patients with long-term COVID-19 infections. This worsening of fatigue occurs after physical, cognitive, or emotional exertion that exceeds the individual's capacity.
changes in muscle tissue
“There are clear changes in the muscles of these patients,” said Professor Michel van Vugt. These changes were evident in the blood and muscle tissue analysis performed one week before his cycling test and one day after his cycling test.
“We observed a variety of abnormalities in the patients' muscle tissue. At the cellular level, we found that muscle mitochondria, also known as the cell's energy factories, were less functional, leading to reduced energy production. ” explained Professor Rob Wust.
key insights
“So the cause of fatigue is actually biological. Your brain needs energy to think. You need energy to move your muscles. This finding is important for people with long-term COVID-19 infections. “This means we can begin research into appropriate treatments for the disease,” said Professor Van Vugt.
One theory about how long the coronavirus lasts is that coronavirus particles can remain in the body. “We don't see any signs of that in the muscles at this point,” Van Vugt said.
Furthermore, the patient's heart and lung function appeared to be normal, indicating that the persistent fatigue was not due to abnormalities in these organs.
Impact on treatment
The results of this study have important implications for the management of lingering symptoms of the new coronavirus. This result suggests that intense exercise is not necessarily good for long-term patients with COVID-19.
“Decreased exercise capacity is one of the characteristic signs of long-term COVID-19 infection and is accompanied by a significant burden on daily life,” the researchers wrote. “Although ventilation and central cardiovascular system did not limit exercise capacity in long-corona patients, our results support previous suggestions of impaired peripheral skeletal muscle metabolism in long-corona patients.”
Advice for patients
Brent Appelmann, a researcher at Amsterdam UMC, advises patients to exercise within their limits. “Specifically, we advise these patients to adhere to and not exceed their physical limits.”
“Consider light exercise that doesn't make your symptoms worse. Walking or riding an e-bike are good ways to stay in shape. Keep in mind that each patient has different limits,” says Appelman. he said.
“Some classical rehabilitation and physical therapy treatments are counterproductive for recovery in these patients, as symptoms can worsen after exercise,” added Professor Van Vugt.
Understanding the long-lasting coronavirus
It is estimated that one in eight patients will develop long-term Covid, also known as post-Covid syndrome (PCS). A large study of nearly 10,000 Americans found that long-term COVID-19 infections can affect nearly every tissue in the body, with symptoms such as fatigue, brain fog, dizziness, and gastrointestinal upset. It has been found that it can affect the body and organs.
Notably, long-term COVID-19 infections were more prevalent and severe in people infected before the 2021 Omicron variant. The researchers also identified 12 symptoms that most characterize long-term cases of COVID-19, including fatigue after exertion and problems with sexual desire and performance.
Further research has proposed several mechanisms for the development of prolonged COVID-19 infection, including immune dysregulation, microbiota disruption, autoimmunity, coagulation and endothelial abnormalities, and neurological signaling dysfunction.
Studies have observed changes in immune cells such as T cells and B cells, as well as increased levels of certain cytokines, in people who have had a long COVID-19 infection. Elevated levels of autoantibodies have also been observed in patients with long-term COVID-19 infection.
The research will be published in a journal nature communications.
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