Wernhart, Simon, Weihe, Eberhard, Totzeck, Matthias et al. · Journal of clinical medicine · 2023 · DOI
This study tested athletes who had lingering exercise problems and post-exertional malaise (feeling worse after physical activity) following COVID-19. Researchers used a special exercise test to measure how their hearts, lungs, and muscles responded to activity. They found that some athletes showed abnormal responses on these tests, particularly in how efficiently their bodies used oxygen during exercise, which may help identify who needs to limit their training intensity.
This research provides objective testing methods to identify exercise limitations in post-COVID athletes with ME/CFS-like symptoms, potentially helping clinicians and patients make safer training decisions. The findings suggest that standard cardiopulmonary testing may reveal abnormalities not apparent from symptoms alone, supporting the physiological basis of post-exertional malaise rather than attributing it solely to deconditioning.
This study does not establish causation between COVID-19 and these cardiopulmonary abnormalities, nor does it prove that CPET abnormalities cause post-exertional malaise. The cross-sectional design cannot determine whether these findings persist long-term or improve with time. Results are specific to this athlete population and may not generalize to non-athletes with post-COVID ME/CFS or to different geographic/demographic populations.
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
Wernhart, Simon, Weihe, Eberhard, Totzeck, Matthias, Balcer, Bastian, Rassaf, Tienush, & Luedike, Peter (2023). Cardiopulmonary Profiling of Athletes with Post-Exertional Malaise after COVID-19 Infection-A Single-Center Experience.. Journal of clinical medicine. https://doi.org/10.3390/jcm12134348
BibTeX
@article{mecfsatlas-wernhart-2023-cardiopulmonary-profiling,
author = {Wernhart, Simon and Weihe, Eberhard and Totzeck, Matthias and Balcer, Bastian and Rassaf, Tienush and Luedike, Peter},
title = {Cardiopulmonary Profiling of Athletes with Post-Exertional Malaise after COVID-19 Infection-A Single-Center Experience.},
journal = {Journal of clinical medicine},
year = {2023},
doi = {10.3390/jcm12134348},
note = {PubMed: 37445382},
url = {https://www.mecfsatlas.com/evidence/wernhart-2023-cardiopulmonary-profiling},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/wernhart-2023-cardiopulmonary-profiling
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