Review A Review Article on Exercise Intolerance in Long COVID: Unmasking the Causes and Optimizing Treatment Strategies, 2023, Koleničová et al

There is a growing body of research on SARS-CoV-2 (PASC), previously known as the post-COVID syndrome, a chronic condition characterized by symptoms that persist after SARS-CoV-2 infection. Among these symptoms, feelings of physical exhaustion and prolonged fatigue are particularly prevalent and can significantly impact patients’ quality of life. These symptoms are associated with reduced overall physical capacity, decreased daily physical activity, malaise after intense training, and intolerance to physical activity (IFA). IFA, described as a reduced ability to perform physical activities typical for the patient's age, can often lead to a sedentary lifestyle. Prolonged physical inactivity can cause deterioration in the overall physical condition and disrupt mitochondrial function, triggering a vicious cycle of gradual symptom worsening. The underlying causes of PASC remain unclear; however, several biochemical mechanisms have been discussed to explain the body’s energy depletion, and a multidisciplinary approach that combines physical and cognitive rehabilitation and lifestyle interventions such as exercise and diet modifications has been suggested to improve the overall health and well-being of PASC patients.

This critical review aims to review the existing research on the possible causes and links among chronic fatigue, reduced physical activity, and exercise intolerance in patients with PASC. Further research into the underlying causes and treatment of PASC and the importance of developing individualized treatment is needed to address each patient’s unique health requirements.

Open access, https://medscimonit.com/abstract/index/idArt/941079

 

Conclusions

Intolerance to physical activity is a commonly reported symptom of PASC. This limiting condition prevents individuals from engaging in physical activity or exercise due to persistent symptoms or complications after overcoming an infectious disease. These symptoms include fatigue, shortness of breath, chest pain, and muscle weakness. A growing body of research suggests that individuals who recovered from COVID-19 tend to have reduced exercise capacity, muscle weakness, increased levels of inflammation, and oxidative stress compared to a healthy control group, which may present essential factors contributing to intolerance to physical activity. A predisposing suboptimal mitochondrial phenotype resulting from comorbidity, age, and/or previous poor lifestyle leads to reduced mitochondrial function and health status disruptions. Research suggests that a previously suboptimal or virus-altered mitochondrial function could contribute to morbidity in SARS-CoV-2 infection.

Therefore, improving mitochondrial health could be vital in preventing and treating patients with PASC. Approaches such as restricting caloric intake, incorporating appropriate physical activity, regular antioxidant supplementation, or photobiomodulation therapy are possible forms of treatment that suppress inflammatory pathways or promote antioxidant processes and may positively impact homeostasis in these patients [80].

 

Bad patients. Problem solved.

 

As in: "We have zero evidence that any of these approaches actually work, but it sounds nice." You've proposed a hypothesis, so test it. That's science. For now, I'll add these people to the ranks of people who are "working on a free-energy machine, which will be totally awesome once we get it working".