Faghy, Mark A, Duncan, Rae, Hume, Emily et al. · Progress in cardiovascular diseases · 2024 · DOI
Long Covid affects millions of people worldwide with over 200 recognized symptoms that severely impact daily life. A key feature is post-exertional malaise (PEM)—a condition where symptoms dramatically worsen 24-72 hours after physical, mental, or emotional activity, sometimes lasting weeks. This review examines how to safely design rehabilitation programs for Long Covid patients while using objective monitoring tools to track how individuals respond to different activities and prevent symptom flare-ups.
This review directly addresses a core feature of Long Covid (and ME/CFS) that prevents patients from participating in rehabilitation—post-exertional malaise. By highlighting the prevalence and debilitating nature of PESE and calling for evidence-based, patient-safe guidelines with objective monitoring, the authors provide a framework that could improve clinical practice and reduce iatrogenic harm from inappropriate exercise prescriptions.
As a narrative review, this does not prove the efficacy of any specific rehabilitation intervention or monitoring device; it synthesizes existing literature rather than testing hypotheses with primary data. The review does not establish causation for PESE mechanisms or determine which objective monitoring tools are most reliable and predictive of symptom exacerbation in individual patients.
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
Faghy, Mark A, Duncan, Rae, Hume, Emily, Gough, Lewis, Roscoe, Clare, Laddu, Deepika, et al. (2024). Developing effective strategies to optimize physical activity and cardiorespiratory fitness in the long Covid population- The need for caution and objective assessment.. Progress in cardiovascular diseases. https://doi.org/10.1016/j.pcad.2024.03.003
BibTeX
@article{mecfsatlas-faghy-2024-developing-effective,
author = {Faghy, Mark A and Duncan, Rae and Hume, Emily and Gough, Lewis and Roscoe, Clare and Laddu, Deepika and Arena, Ross and Asthon, Ruth E M and Dalton, Caroline},
title = {Developing effective strategies to optimize physical activity and cardiorespiratory fitness in the long Covid population- The need for caution and objective assessment.},
journal = {Progress in cardiovascular diseases},
year = {2024},
doi = {10.1016/j.pcad.2024.03.003},
note = {PubMed: 38460898},
url = {https://www.mecfsatlas.com/evidence/faghy-2024-developing-effective},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/faghy-2024-developing-effective
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