患有长期COVID的患者经常抱怨持续疲劳,肌痛,睡眠问题,认知功能障碍,和劳累后的不适。没有关于长期COVID患者的诱发肌电位(M波)或运动引起的改变的EMG记录数据,提供肌膜疲劳的证据。超过一半的患者在感染性疾病后发生肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS),尤其是病毒性疾病。这些患者中有很大一部分(约70%)在运动期间和运动后患有M波改变的神经肌肉疾病。我们的假设是,在长期COVID患者中也会发现M波改变,与神经肌肉症状有关,类似于ME/CFS。
这项回顾性观察性ColGEM(CovidLonGEncéphalomeeliteMyalgique)研究比较了在COVID大流行之前出现的59例长COVID患者和55例有严重感染史的ME/CFS患者。所有这些患者都接受了相同的方案,包括针对神经和神经肌肉疾病的问卷调查以及股直肌的M波记录,during,和10分钟后,一个渐进的自行车运动。还测量了最大握力(MHGS)和最大运动力。使用非参数检验和参数检验比较两组的症状频率和M波变化幅度。
疲劳的频率,肌痛,睡眠问题,认知功能障碍,两组的劳累后不适以及运动引起的M波改变的幅度相同。相比之下,消化问题在长型COVID中较少出现。当测量到最高的肌肉力量和最高的运动表现时,ME/CFS患者的M波改变更大。
长COVID和ME/CFS之间的这些高度临床和生物学相似性支持以下假设:SARS-Cov-2感染可导致ME/CFS症状。试用注册回顾性注册。
Patients with long-COVID often complain of continuous fatigue, myalgia, sleep problems, cognitive dysfunction, and post-exertional malaise. No data are available on EMG recording of evoked myopotentials (M-waves) or exercise-induced alterations in long-COVID patients, providing evidence of muscle membrane fatigue. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) develops in more than half of patients after an infectious disease, particularly viral diseases. A large proportion (around 70%) of these patients have neuromuscular disorders with M-wave alterations during and after exercise. Our hypothesis was that M-wave alterations would be also found in long-COVID patients, in association with neuromuscular symptoms, similar to ME/CFS.
This retrospective observational ColGEM (Covid LonG Encéphalomyelite Myalgique) study compared 59 patients with long-COVID and 55 ME/CFS patients with a history of severe infection who presented before the COVID pandemic. All of these patients underwent the same protocol consisting of a questionnaire focusing on neural and neuromuscular disorders and M-wave recording in the rectus femoris muscle before, during, and 10 min after a progressive cycling exercise. Maximal handgrip strength (MHGS) and maximal exercise power were also measured. The frequency of symptoms and magnitude of M-wave changes in the two groups were compared using non-parametric and parametric tests.
The frequency of fatigue, myalgia, sleep problems, cognitive dysfunction, and post-exertional malaise as well as the magnitude of exercise-induced M-wave alterations were the same in the two groups. By contrast, digestive problems were less present in long-COVID. M-wave alterations were greater in ME/CFS patients as in those with long-COVID when the highest muscle strength and highest exercise performance were measured.
These high clinical and biological similarities between long-COVID and ME/CFS support the hypothesis that SARS-Cov-2 infection can cause ME/CFS symptoms. Trial registration Registered retrospectively.