Should we be careful with exercise in post-exertional malaise after long COVID?

Christiaan G J Saris^{1

2}, Baziel G M van Engelen^{3

4}, Mirian C H Janssen^{4

5}, Benno Kusters^{4

6}, Richard J T Rodenburg^{4

7}, David E Sluijs⁸, Nicoline B M Voet^{4

9

10}

Affiliations

¹ Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands. c.saris@radboudumc.nl.
² Radboud center for mitochondrial medicine, Nijmegen, The Netherlands. c.saris@radboudumc.nl.
³ Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
⁴ Radboud center for mitochondrial medicine, Nijmegen, The Netherlands.
⁵ Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
⁶ Department of Pathology, Radboud university medical center, Nijmegen, The Netherlands.
⁷ Department of Laboratory Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
⁸ Sports Medicine Center, HAN Seneca, HAN University of Applied Sciences, Nijmegen, The Netherlands.
⁹ Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
¹⁰ Klimmendaal, Rehabilitation Center, Arnhem, The Netherlands.

Christiaan G J Saris et al. Nat Commun. 2025.

. 2025 Feb 18;16(1):1724.

doi: 10.1038/s41467-025-56427-3.

Christiaan G J Saris^{1

2}, Baziel G M van Engelen^{3

4}, Mirian C H Janssen^{4

5}, Benno Kusters^{4

6}, Richard J T Rodenburg^{4

7}, David E Sluijs⁸, Nicoline B M Voet^{4

9

10}

¹ Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands. c.saris@radboudumc.nl.
² Radboud center for mitochondrial medicine, Nijmegen, The Netherlands. c.saris@radboudumc.nl.
³ Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
⁴ Radboud center for mitochondrial medicine, Nijmegen, The Netherlands.
⁵ Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
⁶ Department of Pathology, Radboud university medical center, Nijmegen, The Netherlands.
⁷ Department of Laboratory Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
⁸ Sports Medicine Center, HAN Seneca, HAN University of Applied Sciences, Nijmegen, The Netherlands.
⁹ Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
¹⁰ Klimmendaal, Rehabilitation Center, Arnhem, The Netherlands.

No abstract available

Conflict of interest statement

Competing interests: The authors declare no competing interests.

1. Appelman, B. et al. Muscle abnormalities worsen after post-exertional malaise in long COVID. Nat. Commun.15, 17 (2024). - PMC - PubMed
1. Norweg, A. et al. Exercise intolerance associated with impaired oxygen extraction in patients with long COVID. Respir. Physiol. Neurobiol.313, 104062 (2023). - PMC - PubMed
1. Schafer, H., Teschler, M., Mooren, F. C. & Schmitz, B. Altered tissue oxygenation in patients with post COVID-19 syndrome. Microvasc. Res.148, 104551 (2023). - PMC - PubMed
1. Durstenfeld, M. S. et al. Use of cardiopulmonary exercise testing to evaluate long COVID-19 symptoms in adults: a systematic review and meta-analysis. JAMA Netw. Open5, e2236057 (2022). - PMC - PubMed
1. Guarnieri, J. W. et al. Core mitochondrial genes are down-regulated during SARS-CoV-2 infection of rodent and human hosts. Sci. Transl. Med.15, eabq1533 (2023). - PMC - PubMed