Exercise Pathophysiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of SARS-CoV-2: More in Common Than Not?

Overview

Journal Chest

Publisher Elsevier

Specialty Pulmonary Medicine

Date 2023 Apr 13

PMID 37054777

Authors

Phillip Joseph

Inderjit Singh

Rudolf Oliveira

Christine A Capone

Mary P Mullen

Dane B Cook

Mary Catherine Stovall

Johanna Squires

Kristine Madsen

Aaron B Waxman

David M Systrom

Affiliations

Soon will be listed here.

Abstract

Topic Importance: Postacute sequelae of SARS-CoV-2 (PASC) is a long-term consequence of acute infection from COVID-19. Clinical overlap between PASC and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has been observed, with shared symptoms including intractable fatigue, postexertional malaise, and orthostatic intolerance. The mechanistic underpinnings of such symptoms are poorly understood.

Review Findings: Early studies suggest deconditioning as the primary explanation for exertional intolerance in PASC. Cardiopulmonary exercise testing reveals perturbations related to systemic blood flow and ventilatory control associated with acute exercise intolerance in PASC, which are not typical of simple detraining. Hemodynamic and gas exchange derangements in PASC have substantial overlap with those observed with ME/CFS, suggestive of shared mechanisms.

Summary: This review illustrates exercise pathophysiologic commonalities between PASC and ME/CFS that will help guide future diagnostics and treatment.

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