People with Long COVID and ME/CFS Exhibit Similarly Impaired Dexterity and Bimanual Coordination: A Case-Case-Control Study.
Sanal-Hayes, Nilihan E M, Hayes, Lawrence D, Mclaughlin, Marie et al. · The American journal of medicine · 2025 · DOI
Quick Summary
This study tested hand coordination and fine motor skills in people with long COVID and ME/CFS using a simple pegboard task where participants place small pegs into holes as quickly and accurately as possible. Both patient groups performed similarly to each other but notably worse than healthy people, suggesting that problems with hand coordination and dexterity are common to both conditions. The findings highlight that these motor difficulties deserve specific medical attention and treatment in both long COVID and ME/CFS patients.
Why It Matters
This is the first direct comparison of motor coordination between long COVID and ME/CFS patients, providing evidence that these conditions share similar neuromotor impairments. Identifying comparable motor dysfunction in both conditions strengthens the biological basis for understanding these illnesses and creates an urgent case for developing targeted rehabilitation interventions for motor difficulties that have previously received limited clinical attention.
Observed Findings
People with ME/CFS and long COVID performed similarly on pegboard tests (no significant difference between groups)
Both ME/CFS and long COVID groups performed significantly worse than healthy controls on pegboard tests
This pattern held across multiple pegboard test variations
Findings were consistent despite the long COVID group having much shorter illness duration (~16 months vs ~16 years)
Inferred Conclusions
Dexterity and bimanual coordination impairments are a shared feature of both ME/CFS and long COVID
Motor coordination deficits are present early in long COVID illness and persist through ME/CFS's chronic phase
Targeted interventions for dexterity and coordination should be developed and evaluated for both patient populations
Remaining Questions
What causes the motor coordination impairments in these conditions—is it neurological, muscular, central processing, or multifactorial?
Do motor deficits improve, worsen, or remain stable over time within each condition?
How do these motor impairments affect patients' quality of life and functional abilities in daily activities?
What This Study Does Not Prove
This study does not establish the mechanisms causing impaired dexterity or prove that motor deficits are caused by the same underlying pathology in both conditions. The cross-sectional design cannot determine whether motor impairment develops early or late in illness, worsens over time, or responds to any specific interventions. Sample sizes are relatively modest, limiting statistical power.
Tags
Phenotype:Long COVID Overlap
Method Flag:Weak Case DefinitionSmall SampleExploratory Only