E2 ModerateModerate confidencePEM requiredCross-SectionalPeer-reviewedReviewed
Impaired Hand Grip Strength Correlates with Greater Disability and Symptom Severity in Post-COVID Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
Paffrath, Anna, Kim, Laura, Kedor, Claudia et al. · Journal of clinical medicine · 2024 · DOI
Quick Summary
Researchers tested hand grip strength in 144 women with long-COVID symptoms, comparing those who met strict ME/CFS criteria (78 patients) with those who had other long-COVID symptoms. People with ME/CFS showed weaker grip strength and more severe disability, fatigue, and symptom worsening after activity compared to other long-COVID patients. Weak grip strength appeared to be connected to the core symptoms that define ME/CFS, suggesting muscle weakness in ME/CFS may share a common cause with other hallmark symptoms.
Why It Matters
This study provides objective biological evidence that ME/CFS after COVID differs mechanistically from other long-COVID presentations, validating the distinct clinical status of ME/CFS. The correlation between grip strength and ME/CFS-specific symptoms suggests researchers should investigate shared underlying mechanisms, potentially leading to targeted diagnostics and treatments for this severe subtype.
Observed Findings
- Patients with ME/CFS had significantly lower hand grip strength and greater physical disability (p < 0.001) compared to other PCS patients.
- Hand grip strength correlated with physical function across all PCS patients (p < 0.001).
- In ME/CFS patients only, impaired grip strength was significantly associated with symptom severity, fatigue, postexertional malaise, and autonomic dysfunction.
- ME/CFS patients reported significantly more severe symptoms overall, including greater fatigue and postexertional malaise than other PCS patients.
Inferred Conclusions
- Hand grip strength is an objective marker of physical function impairment in post-COVID patients broadly.
- The unique association between grip strength and hallmark ME/CFS symptoms in the ME/CFS subgroup suggests a distinct common pathophysiological mechanism underlying muscle dysfunction and symptom severity in ME/CFS, separate from other PCS manifestations.
- ME/CFS represents a biologically distinct subtype of long-COVID rather than a milder variant.
Remaining Questions
- What underlying pathophysiological mechanisms link muscle fatigue and ME/CFS-specific symptoms that do not apply to other PCS types?
- Does grip strength impairment precede symptom development in ME/CFS, or do symptoms and weakness develop simultaneously?
What This Study Does Not Prove
This study does not prove that impaired grip strength causes ME/CFS symptoms or vice versa—it only shows they correlate. The cross-sectional design means we cannot determine temporal relationships or causality. The findings apply only to female patients with post-COVID ME/CFS and may not generalize to other ME/CFS populations or men with similar conditions.
Tags
Symptom:Post-Exertional MalaiseCognitive DysfunctionOrthostatic IntoleranceFatiguePain
Biomarker:Blood Biomarker
Phenotype:Infection-TriggeredSevereLong COVID Overlap
Method Flag:Small SampleStrong PhenotypingSex-StratifiedMixed Cohort
Metadata
- DOI
- 10.3390/jcm13072153
- PMID
- 38610918
- Review status
- Editor reviewed
- Evidence level
- Single-study or moderate support from human research
- Last updated
- 12 April 2026
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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