ArticleNature communications2024
Muscle abnormalities worsen after post-exertional malaise in long COVID.
Article in Nature communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05225688 (Skeletal Muscle Structure and Function in Relation to Post-exertional Malaise in Patients With PASC and ME/CFS), which is not on this map. Cited by 214 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Skeletal Muscle Structure and Function in Relation to Post-exertional Malaise in Patients With PASC and ME/CFS
Who cites it
214 citing papers in PubMed, 3 syntheses or guidelines pooled it, 300 citations in OpenAlex.
- Pathophysiological mechanisms of post-exertional malaise: an integrative analysis based on the metabolism-immune-neuro interaction model.Frontiers in immunology · 2026Pooled it
- Prevalence and prognosis of sarcopenia in acute COVID-19 and long COVID: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Symptom Trajectories and Clinical Subtypes in Post-COVID-19 Condition: Systematic Review and Clustering Analysis.JMIR public health and surveillance · 2025Pooled it
- Trial
- Trial
- Muscle Abnormalities in Nonhospitalised Patients With Post-COVID-19 Condition.Journal of cachexia, sarcopenia and muscle · 2025Trial
- Feasibility, acceptance and effects of pulsed magnetic field therapy in patients with post-COVID-19 fatigue syndrome : A randomized controlled pilot study.Wiener klinische Wochenschrift · 2025Trial
- Post-Hospitalisation COVID-19 Rehabilitation (PHOSP-R): a randomised controlled trial of exercise-based rehabilitation.The European respiratory journal · 2025Trial
- Trial
- Effects of a symptom-titrated exercise program on fatigue and quality of life in people with post-COVID condition - a randomized controlled trial.Scientific reports · 2024Trial
- Transcutaneous electrical nerve stimulation for fibromyalgia-like syndrome in patients with Long-COVID: a pilot randomized clinical trial.Scientific reports · 2024Trial
- Using hyperpolarised xenon magnetic resonance imaging to explore breathlessness in long COVID: results from the EXPLAIN study.ERJ open research · 2026Article
- Pandemic-era changes in obesity-associated disabling arthritis burden among United States adults: a repeated cross-sectional study.Clinical rheumatology · 2026Article
- [The importance of psychiatry in the care and research of Post-COVID].Der Nervenarzt · 2026Review
- Article
- Persistent Redox Imbalance in Post-COVID-19 Syndrome: Lipid Peroxidation, Antioxidant Enzyme Depletion, and Reduced Nitric Oxide Availability in an Amazonian Population.Antioxidants (Basel, Switzerland) · 2026Article
- Review
- eNOS Uncoupling, Shear-Stress Tolerance, and the Two-Threshold Model of Post-Exertional Malaise in Long COVID: A Mechanistic Hypothesis With Implications for Physiotherapy and Recovery Protocols.Microcirculation (New York, N.Y. : 1994) · 2026Review
- Long-term impact of COVID-19 on haemophilia: a multicenter study in Southwest China.BMC infectious diseases · 2026Article
- Skeletal muscle properties in long COVID and ME/CFS differ from those induced by bed rest.Nature communications · 2026Article
154 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A subgroup of patients infected with SARS-CoV-2 remain symptomatic over three months after infection. A distinctive symptom of patients with long COVID is post-exertional malaise, which is associated with a worsening of fatigue- and pain-related symptoms after acute mental or physical exercise, but its underlying pathophysiology is unclear. With this longitudinal case-control study (NCT05225688), we provide new insights into the pathophysiology of post-exertional malaise in patients with long COVID. We show that skeletal muscle structure is associated with a lower exercise capacity in patients, and local and systemic metabolic disturbances, severe exercise-induced myopathy and tissue infiltration of amyloid-containing deposits in skeletal muscles of patients with long COVID worsen after induction of post-exertional malaise. This study highlights novel pathways that help to understand the pathophysiology of post-exertional malaise in patients suffering from long COVID and other post-infectious diseases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.