Muscle abnormalities worsen after post-exertional malaise in long COVID, 2023/4, Wüst, van Vugt, Appelman et al

I did a kind of experiment on myself while I had about 5 weeks of post-COVID symptoms (mostly cognitive issues + light sensitivity + fatigue, feeling like I needed to turn it in for the day by 1 pm). I had regular exposure to cognitive exertion by trying to work intensively as normal - I always recovered from it come the next morning. I tried vigorous cardio on an exercise bike for about 30 minutes, one time early in the day before I was wiped out and once late in the day after I was wiped out. Both times, I got very dizzy and cognitively useless and woke up still feeling the same for all of the following day, but much more strongly in the latter case where I was already cognitively exhausted before exercising. Felt like it transported me a fortnight backwards. I had no muscle pain or weakness in any of these scenarios.

So yes, my experience with a kind of PEM was definitely exercise-induced and not cognitively-induced. Just another anecdote and I am sure others may have different experiences and I do not wish to minimise those.

Sidenote (speaking of anecdotes) at another time I was disabled for nearly a year with effectively no physical activity and very minimised manual activity around the house. I had objective deconditioning evident from hand-grip strength tests recorded over time and undertaken by an unbiased professional. I had zero ME/CFS / LC -esque symptoms associated with my deconditioning .

So in my experience, empirical muscle deconditioning had no relationship to ME etc as I understand it (as we would expect, not being BPS people), while exercise, specifically, strongly induced something like PEM during a nasty post-COVID period.

 

The Swedish Covid Association published a summary of this study in Swedish, on their website in March 2024

Rubbningar i skelettmuskulatur förvärras i samband med post exertional malaise (PEM)
https://covidforeningen.se/rubbningar-i-skelettmuskulatur-forvarras-i-samband-med-pem/

 

I did a power walk 5 week post Covid infection after I felt recovered and woke up the next morning unable to stand or walk for 3.5 weeks. No negative effect on my cognitive functions. It was not delayed PEM as I experience with M.E.

Same thing happened in 1992 post-infectious viral infection after 9 months. Exercised a bit and couldn't walk for 5-6 months after. It was my first "PEM" experience with no cognitive issues or other symptoms except for my legs muscles that I exercised.

 

Watch! Solve Ramsay Research Grant winner Rob Wüst, PhD presents "Skeletal Muscle Fatigue & Post-Exertional Malaise (PEM) in People with Long Covid & Implications for ME/CFS."

Dr. Wüst received a Solve M.E. Ramsay Research Grant in 2022 to study muscle pain, PEM, and treatments for pain and malaise in patients with diseases like Long Covid and ME/CFS. He found that, at the physiological and molecular levels, PEM differs from general fatigue. These differences have big implications for how physical exercise affects patients with Long Covid or ME/CFS.

In this webinar, Dr. Wüst updates us on his studies of these two central symptoms of Long Covid and ME/CFS (PEM and general fatigue), and answers questions from attendees.

Watch here:
https://ow.ly/fXYf50TCPwQ

 

See also Persistent Fatigue, Weakness, and Aberrant Muscle Mitochondria in Survivors of Critical COVID-19 (2024, Critical Care Explorations) for some similar findings in post ICU/Covid patients.