Joseph, Phillip, Singh, Inderjit, Oliveira, Rudolf et al. · Chest · 2023 · DOI
This review compares how the body responds to exercise in people with long COVID (PASC) and ME/CFS, two conditions that share similar symptoms like extreme tiredness and worsening symptoms after activity. Researchers found that both conditions show similar abnormalities in heart function, blood flow, and breathing during exercise that go beyond simple deconditioning or being out of shape. These shared patterns suggest both conditions may involve similar underlying biological problems, which could help doctors develop better tests and treatments.
This research validates that ME/CFS and long COVID share common biological problems during exercise, legitimizing the experiences of both patient populations and suggesting that treatments developed for one condition may be relevant to the other. Understanding these shared mechanisms could accelerate development of diagnostic tests and therapeutic strategies that benefit both communities. The comparison also highlights that ME/CFS research findings from decades of study may inform emerging PASC research.
This systematic review does not prove that PASC and ME/CFS are caused by identical mechanisms, only that they share overlapping exercise-related abnormalities. The review cannot establish which specific biological pathways drive these abnormalities or definitively rule out multiple different mechanisms producing similar presentations. It also does not provide data on treatment efficacy or establish clear diagnostic criteria for either condition.
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 →
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