E2 ModerateModerate confidencePEM ?Case-ControlPeer-reviewedMachine draft
People with Long Covid and ME/CFS Exhibit Similarly Impaired Balance and Physical Capacity: A Case-Case-Control Study.
Hayes, Lawrence D, Sanal-Hayes, Nilihan E M, Mclaughlin, Marie et al. · The American journal of medicine · 2025 · DOI
Quick Summary
This study compared balance and physical strength in people with long COVID, people with ME/CFS, and healthy volunteers. Both long COVID and ME/CFS patients showed significantly worse balance during standing and took longer to perform simple physical tasks like standing up from a chair compared to healthy people. Importantly, the balance and strength problems were equally severe in both groups, despite long COVID being a much newer illness.
Why It Matters
This finding is crucial because it demonstrates that long COVID and ME/CFS share similar objective physical impairments in balance and capacity despite vastly different disease durations, suggesting common underlying pathophysiology. This evidence strengthens the case for developing shared interventions and recognizing long COVID as potentially following an ME/CFS-like trajectory. It validates the serious physical limitations experienced by ME/CFS patients by showing these deficits are measurable, not subjective, and appear consistent across different patient populations.
Observed Findings
- Both long COVID and ME/CFS groups demonstrated significantly worse postural sway during static standing compared to healthy controls, with no statistically significant difference between the two patient groups.
- Both long COVID and ME/CFS groups performed worse on the Timed Up and Go test compared to controls, with similar impairment levels between groups.
- Both long COVID and ME/CFS groups performed worse on the 5 Times Sit to Stand test compared to controls, with similar impairment levels between groups.
- 87% of long COVID and ME/CFS participants combined exceeded muscle weakness thresholds on the Sit to Stand test.
- Only 13% of long COVID and ME/CFS participants exceeded muscle weakness thresholds on the Timed Up and Go test.
Inferred Conclusions
- People with long COVID and people with ME/CFS have similarly impaired balance and physical capacity despite very different illness durations, suggesting potentially shared underlying pathophysiology.
- Postural sway and physical capacity impairment are hallmark features of both conditions and represent urgent targets for intervention development.
- The similarity in objective physical deficits between groups suggests that long COVID may follow a comparable clinical course to ME/CFS if adequate interventions are not developed.
- Muscle weakness appears to be the primary physical limitation distinguishing both patient populations from healthy controls.
What This Study Does Not Prove
This study does not prove that long COVID will inevitably progress to ME/CFS-like chronicity, nor does it establish the mechanisms causing balance and strength impairment. The similar findings at different disease timepoints do not demonstrate that the same disease process is occurring in both conditions. Additionally, cross-sectional data cannot show whether these impairments improve, worsen, or remain stable over time in either population.
Tags
Symptom:Fatigue
Phenotype:Long COVID Overlap
Method Flag:Weak Case DefinitionSmall Sample