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Post-COVID exercise intolerance is associated with capillary alterations and immune dysregulations in skeletal muscles

Title: Post-COVID exercise intolerance is associated with capillary alterations and immune dysregulations in skeletal muscles
Authors: Tom Aschman; Emanuel Wyler; Oliver Baum; Andreas Hentschel; Rebekka Rust; Franziska Legler; Corinna Preusse; Lil Meyer-Arndt; Ivana Büttnerova; Alexandra Förster; Derya Cengiz; Luiz Gustavo Teixeira Alves; Julia Schneider; Claudia Kedor; Judith Bellmann-Strobl; Aminaa Sanchin; Hans-Hilmar Goebel; Markus Landthaler; Victor Corman; Andreas Roos; Frank L. Heppner; Helena Radbruch; Friedemann Paul; Carmen Scheibenbogen; Nora F. Dengler; Werner Stenzel
Source: Acta Neuropathologica Communications, Vol 11, Iss 1, Pp 1-20 (2023)
Publisher Information: BMC
Publication Year: 2023
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: SARS-CoV-2; Post-COVID syndrome; Post-acute sequelae of COVID-19 (PASC); Post-infectious syndrome; Microangiopathy; Basement membrane thickening; Neurology. Diseases of the nervous system; RC346-429
Description: The SARS-CoV-2 pandemic not only resulted in millions of acute infections worldwide, but also in many cases of post-infectious syndromes, colloquially referred to as “long COVID”. Due to the heterogeneous nature of symptoms and scarcity of available tissue samples, little is known about the underlying mechanisms. We present an in-depth analysis of skeletal muscle biopsies obtained from eleven patients suffering from enduring fatigue and post-exertional malaise after an infection with SARS-CoV-2. Compared to two independent historical control cohorts, patients with post-COVID exertion intolerance had fewer capillaries, thicker capillary basement membranes and increased numbers of CD169+ macrophages. SARS-CoV-2 RNA could not be detected in the muscle tissues. In addition, complement system related proteins were more abundant in the serum of patients with PCS, matching observations on the transcriptomic level in the muscle tissue. We hypothesize that the initial viral infection may have caused immune-mediated structural changes of the microvasculature, potentially explaining the exercise-dependent fatigue and muscle pain. Graphical Abstract
Document Type: article in journal/newspaper
Language: English
Relation: https://doi.org/10.1186/s40478-023-01662-2; https://doaj.org/toc/2051-5960; https://doaj.org/article/b65fc0fea9634e6a9d9eb0b43f7c5637
DOI: 10.1186/s40478-023-01662-2
Availability: https://doi.org/10.1186/s40478-023-01662-2; https://doaj.org/article/b65fc0fea9634e6a9d9eb0b43f7c5637
Accession Number: edsbas.BA968A46
Database: BASE