Bizjak, Daniel Alexander, Ohmayer, Birgit, Buhl, Jasmine Leonike et al. · International journal of molecular sciences · 2024 · DOI
This study examined the energy-producing structures (mitochondria) inside muscle cells of people with ME/CFS and long COVID, comparing them to healthy people. Researchers found that mitochondria in both conditions work less efficiently and have structural damage, but the patterns differ: long COVID shows more damage to a specific energy-producing pathway, while ME/CFS shows more overall structural wear and tear in the mitochondria themselves.
This work provides objective biological evidence that mitochondrial dysfunction underlies fatigue in both ME/CFS and long COVID, potentially explaining why patients cannot sustain physical activity. Identifying distinct mitochondrial damage patterns between the two conditions may help clinicians differentiate them and could guide future targeted treatments aimed at restoring energy production in muscle.
This cross-sectional study cannot prove that mitochondrial changes *cause* fatigue or reduced performance—only that they correlate with it. The study does not establish whether mitochondrial damage precedes symptom onset, develops as a consequence of illness or inactivity, or follows a specific disease progression. It also does not prove the proposed mechanism of virus-induced damage in PCS, only that the pattern differs from CFS.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Bizjak, Daniel Alexander, Ohmayer, Birgit, Buhl, Jasmine Leonike, Schneider, Elisabeth Marion, Walther, Paul, Calzia, Enrico, et al. (2024). Functional and Morphological Differences of Muscle Mitochondria in Chronic Fatigue Syndrome and Post-COVID Syndrome.. International journal of molecular sciences. https://doi.org/10.3390/ijms25031675
BibTeX
@article{mecfsatlas-bizjak-2024-functional-morphological,
author = {Bizjak, Daniel Alexander and Ohmayer, Birgit and Buhl, Jasmine Leonike and Schneider, Elisabeth Marion and Walther, Paul and Calzia, Enrico and Jerg, Achim and Matits, Lynn and Steinacker, Jürgen Michael},
title = {Functional and Morphological Differences of Muscle Mitochondria in Chronic Fatigue Syndrome and Post-COVID Syndrome.},
journal = {International journal of molecular sciences},
year = {2024},
doi = {10.3390/ijms25031675},
note = {PubMed: 38338957},
url = {https://www.mecfsatlas.com/evidence/bizjak-2024-functional-morphological},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/bizjak-2024-functional-morphological
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