Towards an understanding of physical activity-induced post-exertional malaise: Insights into microvascular alterations and immunometabolic interactions in post-COVID condition and myalgic encephalomyelitis/chronic fatigue syndrome

Publikation: Beitrag in FachzeitschriftÜbersichtsartikel (Review)BeigetragenBegutachtung

Beitragende

  • Simon Haunhorst - , Center for Interdisciplinary Prevention of Diseases Related to Professional Activities, Jena, Germany. (Autor:in)
  • Diana Dudziak - , Universitätsklinikum Jena (Autor:in)
  • Carmen Scheibenbogen - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Martina Seifert - , Deutsches Zentrum für Herz-Kreislaufforschung (DZHK) (Autor:in)
  • Franziska Sotzny - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Carsten Finke - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Uta Behrends - , Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (Autor:in)
  • Konrad Aden - , Universitätsklinikum Schleswig-Holstein Campus Kiel (Autor:in)
  • Stefan Schreiber - , Universitätsklinikum Schleswig-Holstein Campus Kiel (Autor:in)
  • Dirk Brockmann - , Center Synergy of Systems (SynoSys) (Autor:in)
  • Paul Burggraf - , mHealth Pioneers GmbH, Körtestraße 10, 10967, Berlin, Germany. (Autor:in)
  • Wilhelm Bloch - , Deutsche Sporthochschule Köln (Autor:in)
  • Claudia Ellert - , Initiative Long COVID Deutschland, Lemgo, Germany. (Autor:in)
  • Anuradha Ramoji - , Leibniz-Institut für Photonische Technologien (Autor:in)
  • Juergen Popp - , Leibniz-Institut für Photonische Technologien (Autor:in)
  • Philipp Reuken - , Universitätsklinikum Jena (Autor:in)
  • Martin Walter - , Deutsches Zentrum für Psychische Gesundheit (DZPG) (Autor:in)
  • Andreas Stallmach - , Universitätsklinikum Jena (Autor:in)
  • Christian Puta - , Universitätsklinikum Jena (Autor:in)

Abstract

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.

PURPOSE AND METHODS: In this review, we describe current evidence indicating that key pathophysiological features of PCC and ME/CFS are involved in physical activity-induced PEM.

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.

Details

OriginalspracheEnglisch
FachzeitschriftInfection
Jahrgang2024
Frühes Online-Datum6 Sept. 2024
PublikationsstatusVeröffentlicht - 6 Sept. 2024
Peer-Review-StatusJa

Externe IDs

PubMed 39240417
Scopus 85203282365

Schlagworte