Changes in muscle from PEM
Muscle abnormalities worsen after post-exertional malaise in long COVID
https://www.sciencedirect.com/science/article/abs/pii/S0049017224000957
Study Summary
This study investigates the biological mechanisms underlying post-exertional malaise (PEM) in Long COVID, focusing on how skeletal muscle abnormalities and metabolic disturbances contribute to exercise intolerance and worsened symptoms after exertion.
Key Findings
Skeletal Muscle Abnormalities: The study found that individuals with Long COVID exhibit structural and functional abnormalities in their skeletal muscles, which are associated with reduced exercise capacity and contribute to PEM.
Metabolic Disturbances: Researchers observed both local and systemic metabolic disturbances in Long COVID patients, including altered energy production and impaired muscle metabolism. These disturbances were exacerbated after exertion, leading to worsened PEM symptoms.
Exercise-Induced Myopathy: The study revealed evidence of severe exercise-induced myopathy in Long COVID patients, indicating muscle damage and dysfunction triggered by physical activity.
Amyloid Deposits: Researchers discovered amyloid-containing deposits in the skeletal muscles of Long COVID patients, which may contribute to inflammation and impaired muscle function. These deposits increased after exertion, further contributing to PEM.
Why It Matters
This study is highly relevant to chronic condition management, particularly for individuals with Long COVID and other conditions characterized by PEM. It provides crucial insights into the underlying biological mechanisms of PEM, which can inform the development of more targeted and effective treatment strategies.
What This Means for Managing Symptoms
Education and Advocacy: I can educate patients about the biological basis of PEM and advocate for their needs in various settings, including work, school, and social environments, to ensure they receive appropriate accommodations and support.
Activity Pacing and Energy Conservation: Understanding the impact of exertion on muscle function and metabolic disturbances in Long COVID, I can support patients in developing effective pacing strategies to avoid overexertion and manage PEM.
Graded Exercise: This research highlights the need for cautious and individualized approaches to exercise in Long COVID. I can support the development graded exercise and activity tailored to each patient's tolerance levels and gradually increase activity without triggering PEM.
Holistic Approach: This study reinforces the importance of a holistic approach to managing Long COVID, addressing not only physical symptoms but also the cognitive, emotional, and social impacts of the condition.
Citation
Appelman, B., Charlton, B.T., Goulding, R.P. et al. (2024). Muscle abnormalities worsen after post-exertional malaise in long COVID. Nature Communications. 15, 17. https://doi.org/10.1038/s41467-023-44432-3