April 4, 2024

expert reaction to trial of exercise intolerance and functional limitations in non-hospitalised long covid patients

A study published in JAMA Network Open looks at exercise intolerance and functional limitations in long COVID patients.

Dr Emily Fraser, Consultant in Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, and clinical lead of the Post COVID clinic in Oxford, said:

“It is good that it has focused on non-hospitalised patients, which make up the overwhelming majority of long covid (LC) patients we look after services these days. Numbers in the study are small.

“It is also good that the authors recognise the issue of post exertional malaise (PEM) and aim to evaluate this as well as elucidate potential physiological mechanisms that may be driving it (i.e looking at nerve conduction/EMG/autonomic/cardiovascular indices).

“My concern is that none of the long covid participants reported PEM at 48h, even after high intensity exercise regimes. This contrasts with our clinical experience where many patients we see will report significant symptom rebound after fairly gentle exercise so I am think great caution needs to be taken in extrapolating these findings to the wider LC population. The authors comment on individualised activity programmes is extremely valid, however, and I think that this needs to be the message. Not all patients struggle with PEM and even those that do, a cautious and flexible approach to physical activity can be beneficial. There is not going to be a single rehab strategy for these patients.”

‘Functional Limitations and Exercise Intolerance in Patients With Post-COVID Condition’ by name of first author et al. was published in JAMA Network Open at 16:00 UK time on Thursday 4^th April.

DOI:10.1001/jamanetworkopen.2024.4386

Declared interests

No reply to our request for DOIs was received.