2024-01-05 19:09:00
Dutch researchers advised avoiding overexertion in patients with long COVID and opting for light physical activity that does not worsen symptoms (Illustrative Image Infobae)
The cases of persistent COVID or long COVID are still one of the biggest mysteries that this pandemic has given rise to and that science continues to study. It includes a wide range of symptoms that occur or persist more than 30 days following infection.
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To better understand the prevalence and severity of symptoms, the US National Institutes of Health (NIH) launched the RECOVER-Adult study, Researching COVID to Enhance Recovery, in June 2023. The results of this study, one of the largest ever, pinpointed the 12 key symptoms of long COVID. The findings, which were published in JAMA.
The 12 characteristic symptoms of long COVID are: discomfort following physical exertion; debilitating fatigue (exacerbated by physical or mental activity); loss or change in smell or taste; dizziness; confusion or brain fog; gastrointestinal symptoms; heart palpitations; chest pain; chronic cough; abnormal movements.
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The symptoms of tiredness and fatigue experienced by people with long COVID have a physical cause, according to researchers, following finding changes in the patients’ muscle cells, according to a recent study.
The study shows the impact on the muscles of patients with prolonged covid symptoms. Muscle cells show lower efficiency in the “power plants” or mitochondria (Illustrative Image Infobae)
A team of scientists from the Netherlands found that the mitochondria of people with long COVID produced less energy than those of healthy patients. The Dutch study was published in the journal Nature Communications.
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These muscle cell “power plants” function less effectively in people with long COVID, according to scientists, which might explain the persistent fatigue that is a hallmark of the condition.
“We are seeing obvious changes in the muscles of these patients,” said the study’s lead author, Michèle van Vugt, professor of internal medicine at Amsterdam University Medical Center (UMC). According to background information from researchers, regarding one in eight COVID patients will experience long COVID.
In the study, van Vugt’s group examined muscle cells from 25 long COVID patients and 21 healthy people. They had all participants participate in a 15-minute cycling session.
At the cellular level, we saw that muscle mitochondria, also known as the cell’s energy factories, function worse and produce less energy,” said the co-author of the study (Getty).
In people with long COVID, exercise caused a temporary worsening of their symptoms, a phenomenon known as post-exertional malaise (PEM). This is where extreme fatigue occurs when someone pushes themselves physically, cognitively, or emotionally beyond their individual threshold.
The researchers examined the blood and muscle tissue of the participants at two points in time: a week before the cycling test and one day following. They did not detect any abnormalities in the patients’ hearts or lungs. However, there were differences between the muscles of people with and without long COVID.
“We saw several abnormalities in the patients’ muscle tissue. At the cellular level, we observed that muscle mitochondria, also known as the energy factories of the cell, function less well and produce less energy,” said study co-author Rob Wüst, assistant professor of human movement sciences at the University of Vrije, in Amsterdam.
“So the cause of fatigue is really biological. The brain needs energy to think. Muscles need energy to move. “This discovery means we can now start investigating a suitable treatment for people with long COVID,” Van Vugt said.
The US Institutes of Health listed 12 key symptoms of long Covid, including fatigue and post-exertional malaise (Getty)
And he added: “Because symptoms can worsen following physical exertion, some classic forms of rehabilitation and physiotherapy are counterproductive to the recovery of these patients.”
Brent Appelman, a researcher at UMC Amsterdam, added: “In concrete terms, we advise these patients to protect their physical limits and not to exceed them.”
“Consider light effort that does not lead to worsening discomfort. Walking is good, or riding a stationary bike, to maintain a certain physical condition. It must be taken into account that each patient has a different limit,” she remarked.
The research did not offer any support for a theory regarding the causes of long COVID, which speculates that coronavirus particles can remain in the bodies of sufferers. “We don’t see any indication of this in the muscles at the moment,” Van Vugt said.
Numerous studies have been carried out around the world to find answers to long covid. Among them was the one carried out by the University of Pennsylvania and other research centers that indicated the connection between the neurological and cognitive symptoms of long COVID and the reduced levels of serotonin in these patients. They identified that chronic inflammation caused by persistent fragments of the virus in the intestine leads to a decrease in serotonin production, triggering communication problems between the intestine and the brain. This lack of serotonin might explain symptoms such as brain fog and long-term memory impairment.
“We are seeing obvious changes in the muscles of these patients,” said the study’s lead author.
Another study, conducted by the Autonomous University of Zacatecas in Mexico, noted that young patients recovered from COVID-19 can experience diverse sequelae, from respiratory and gastrointestinal problems to neurological complications, with a wide range of symptoms persisting following the initial infection.
Researchers at King’s College London conducted another study on the impact of COVID-19 on cognitive function, analyzing more than 3,000 participants across two rounds of online cognitive testing conducted in 2021 and 2022. Published in The Lancet, the The study focused on evaluating 12 cognitive tasks covering memory, attention, reasoning, processing speed, and motor control. They found that those who experienced virus-related symptoms for at least 12 weeks showed reduced cognitive performance, comparable to the effect of a 10-year increase in age.
Furthermore, no significant improvement in cognitive performance was seen in the tests between the two rounds of assessment, conducted nine months apart, even for those who had spent almost two years since the initial infection. Individuals who considered themselves fully recovered following infection showed no significant differences in cognitive performance compared to those who had not had the virus, while those who did not feel fully recovered had lower scores on task accuracy.
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