Charlton Braeden T, Goulding Richie P, Jaspers Richard T, Appelman Brent, van Vugt Michèle, Wüst Rob C I
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, The Netherlands; Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands.
Amsterdam UMC location University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, The Netherlands; Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands.
Trends Endocrinol Metab. 2024 Dec 17. doi: 10.1016/j.tem.2024.11.008.
When acute SARS-CoV-2 infections cause symptoms that persist longer than 3 months, this condition is termed long COVID. Symptoms experienced by patients often include myalgia, fatigue, brain fog, cognitive impairments, and post-exertional malaise (PEM), which is the worsening of symptoms following mental or physical exertion. There is little consensus on the pathophysiology of exercise-induced PEM and skeletal-muscle-related symptoms. In this opinion article we highlight intrinsic mitochondrial dysfunction, endothelial abnormalities, and a muscle fiber type shift towards a more glycolytic phenotype as main contributors to the reduced exercise capacity in long COVID. The mechanistic trigger for physical exercise to induce PEM is unknown, but rapid skeletal muscle tissue damage and intramuscular infiltration of immune cells contribute to PEM-related symptoms.
当急性SARS-CoV-2感染导致症状持续超过3个月时，这种情况被称为“长新冠”。患者常出现的症状包括肌痛、疲劳、脑雾、认知障碍以及运动后不适（PEM），即精神或身体劳累后症状加重。关于运动诱发的PEM和骨骼肌相关症状的病理生理学，目前几乎没有共识。在这篇观点文章中，我们强调内在的线粒体功能障碍、内皮异常以及肌纤维类型向更具糖酵解表型的转变是导致“长新冠”患者运动能力下降的主要因素。体育锻炼诱发PEM的机制尚不清楚，但快速的骨骼肌组织损伤和免疫细胞的肌内浸润会导致与PEM相关的症状。
