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Microvascular and Immunometabolic features of Post-Exertional Malaise in Long COVID and ME/CFS

Background

A considerable number of patients who contracted SARS-CoV-2 are affected by persistent multi-systemic symptoms, referred to as Post-COVID Condition (PCC). Post-exertional malaise (PEM) has been recognized as one of the most frequent manifestations of PCC and is a diagnostic criterion of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Yet, its underlying pathomechanisms remain poorly elucidated.

Results

Upon physical activity, affected patients exhibit a reduced systemic oxygen extraction and oxidative phosphorylation capacity. Accumulating evidence suggests that these are mediated by dysfunctions in mitochondrial capacities and microcirculation that are maintained by latent immune activation, conjointly impairing peripheral bioenergetics. Aggravating deficits in tissue perfusion and oxygen utilization during activities cause exertional intolerance that are frequently accompanied by tachycardia, dyspnea, early cessation of activity and elicit downstream metabolic effects. The accumulation of molecules such as lactate, reactive oxygen species or prostaglandins might trigger local and systemic immune activation. Subsequent intensification of bioenergetic inflexibilities, muscular ionic disturbances and modulation of central nervous system functions can lead to an exacerbation of existing pathologies and symptoms

vk6flab ,
@vk6flab@lemmy.radio avatar

And now in English?

Seriously, is this important information relevant to the general public who has no idea what this is describing?

I might also add that currently this word soup looks a lot like the gibberish coming from chatgpt…

kevindqc ,

From ChatGPT:

This passage describes how certain patients have trouble using oxygen efficiently during physical activity. Their bodies can’t extract enough oxygen or produce energy effectively because of problems with mitochondria (the parts of cells that generate energy) and poor blood circulation. These issues seem to be linked to a lingering, low-level activation of the immune system.

As a result, their muscles and tissues don’t get enough oxygen when they’re active, which leads to symptoms like a fast heartbeat, difficulty breathing, and the need to stop exercising early. Over time, harmful byproducts like lactate (from incomplete energy production), reactive oxygen species (that can damage cells), and prostaglandins (involved in inflammation) build up in the body. This triggers more immune system activity, which worsens the energy problems, disrupts muscle function, and can even affect the brain. This makes existing health issues worse and leads to more severe symptoms during physical exertion.

Neurologist OP ,

hmmm. To be honest, that’s an okay summary out of context, but it really fails to grasp the essence of the paper. It’s not wrong per say, but it adds irrelevant details while withholding key information. I wouldn’t rely on chatgpt’s summary for this.

Neurologist OP , (edited )

There’s a feature of some Long COVID cases (~50%) which is also the defining feature of an illness called ME/CFS which has been caused by various forms of viral infections throughout history. (It is thought that a lot of Long COVID cases are ME/CFS). Anyways this feature is, Post-Exertional Malaise, a worsening of the illness after exertion beyond a certain threshold, which can entail hundreds of symptoms and be permanent.

This paper is a review of some of the biomedical studies looking at what could possibly cause this, and finds there is repeated data of Microvascular (blood vessels) and immunometabolic (metabolic markers relating to immune function) differences with healthy controls.

The leading hypotheses are that this is caused by mitochondrial dysfunction which is mediated by a dysregulated immune system.

Some of my colleagues were co-authors on this paper. I’ll forward the feedback that it is jargony.

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