Soares, Madu N, Eggelbusch, Moritz, Naddaf, Elie et al. · Journal of cachexia, sarcopenia and muscle · 2022 · DOI
Many people with COVID-19 and long COVID experience muscle weakness and tiredness, especially after physical activity. This review examines what happens inside muscle cells in these patients, including muscle fiber shrinkage, changes in how muscles use energy, and immune cell buildup. The authors suggest that severe illness, lack of activity, low oxygen levels, and poor nutrition all contribute to these problems, similar to what happens in other serious conditions.
This review is important for ME/CFS patients and researchers because it draws explicit comparisons between PASC-related muscle dysfunction and chronic fatigue syndrome, two conditions with overlapping symptoms of unexplained weakness and exercise intolerance. Understanding the cellular mechanisms of post-viral muscle dysfunction in COVID-19 may illuminate similar processes in ME/CFS and inform potential therapeutic approaches.
This narrative review does not establish causal mechanisms or provide definitive proof that PASC and ME/CFS share identical pathophysiological pathways. It cannot prove that specific viral or immune factors directly cause muscle dysfunction, as these remain areas of ongoing investigation. The review synthesizes existing literature rather than presenting new experimental or clinical trial data, so its conclusions are only as strong as the evidence base it summarizes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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