Orthostatic and Exercise Intolerance in Recreational and Competitive Athletes With Long COVID, 2022, Rao, Systrom et al

Abstract

Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (PASC) infection is particularly concerning to athletes who place a high premium on cardiovascular performance and competition. This initial case series shows the overlap between PASC and orthostatic intolerance in athletes, reveals the diagnostic challenges, and highlights the role of graded exercise training in this population.

Open access, https://www.sciencedirect.com/science/article/pii/S2666084922005149

 

Wow, this is a nice rebuttal to the "You're out of shape" meme:

This is an apples and oranges comparison because the first test was cycling and the second was rowing, but for what it's worth, his VO2Max before Covid was 49.1. After Covid it was 36.7 mL/min/kg. That's a 25% drop.

The first and third went from being highly trained athletes to being severely disabled.

They recommend exercise...

...but they seem to think this is only applicable to people with dysautonomia-like symptoms:

I just with they were more direct about saying that people with PEM simply don't tolerate exercise.

 

It's such a new concept to them that they just can't wrap their heads around the fact that exercise makes us worse.

 

I wouldn't consider the concept of PEM new to them...one of the authors was Dr. Systrom.

Edit: Typo

 

Dr. Systrom is probably the best exercise intolerance expert out there. Very familiar with the concept of PEM.

Having consulted myself with him before, I am not surprised with the theme of this paper. He is usually associated with Mestinon, which is his drug of choice, but not everyone talks about the gradual exercise program, which is as much recommended by him as the drug. He also prescribes a mitochondrial cocktail, when necessary.
I do believe that exercise has a therapeutic effect, when done correctly. There is plenty of evidence that mitochondria can adapt to aerobic training. But this is easier said than done. It is very hard to pull it off without any professional support. If you overdo, I/R injuries are just around the corner. In general, breaking something is much easier than building it.

My hope is that Bocidelpar will make exercise programs safer for us.

 

Not sure if this is the right thread to post this….

https://twitter.com/user/status/1580676479343394816

 

Really? Preload failure is present in 'all' pwME? Or is it just pwME with POTS?

 

The link to Vimeo film shows as private at the moment.
Think you may need to have to register in order to be able to view.

https://twitter.com/user/status/1580761291685187584