Long COVID and chronic fatigue syndrome/myalgic encephalitis share similar pathophysiologic mechanisms of exercise limitation

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Limited by Small Sample Size: Muscle Oxygen Issues May Explain Exercise Problems in Long COVID and CFS/ME

This small study found similarities in how Long COVID (PASC) and chronic fatigue syndrome/myalgic encephalitis (CFS/ME) patients experience exercise limitations, potentially due to problems with how oxygen gets to and is used by muscles. The researchers also found evidence suggesting that small fiber neuropathy in the skin might be related to these exercise issues in some PASC patients.

Possible Conflicts of Interest

Dr. Levine has a financial interest in Corinthian Reference Labs and CND Life Sciences. Dr. Rischard reports consulting relationships with several companies related to heart/lung conditions and receives research support from various pharmaceutical companies.

Identified Weaknesses

Small Sample Size

The study only included 15 PASC patients, 11 CFS/ME patients, and 11 controls, which is a small sample size to draw definitive conclusions about the populations. Larger studies are needed to confirm the findings.

Self-selection bias for skin biopsy.

Patients in the PASC group who opted for skin biopsies may represent a specific sub-group with more neurological symptoms. This makes it hard to generalize the neuropathy findings to all PASC patients.

Control group issues

The study used two different control groups with different recruitment strategies. This could introduce bias and make it harder to compare the patient groups to a truly representative healthy population.

Rating Explanation

While this study offers interesting insights into the physiological similarities between PASC and CFS/ME during exercise, the small sample size, control group issues, and potential for selection bias significantly limit the generalizability of the findings. The reported conflicts of interest also need to be considered.

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