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Our latest manuscript, “ME/CFS and Long COVID Demonstrate Similar Bioenergetic Impairment and Recovery Failure on Two‑Day Cardiopulmonary Exercise Testing,” is now posted as a preprint. It is under review at Clinical and Translational Metabolism.
Using two‑day cardiopulmonary exercise testing (CPET), we compared physiologic responses in people living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Long COVID, and matched non‑disabled controls, stratifying our analysis by sex.
Here's what we learned:
👉 Both ME/CFS and Long COVID show similar failure to recover after exertion
👉 Largest impairments occur at the ventilatory anaerobic threshold, suggesting similar aerobic system impairment
👉 Females exhibited more pronounced post‑exertional abnormalities than males
👉 No meaningful differences were observed between ME/CFS and Long COVID on two-day CPET, suggesting they share a bioenergetic pathophysiology
👉 Severe functional impairment was common in both patient groups and was not explained by effort preference, deconditioning, ventilation, or hemodynamics
These results reinforce post‑exertional malaise (PEM) is a measurable physiological phenomenon. They underscore the value of two‑day CPET to:
👉 Differentiate PEM from normal recovery using objective measures
👉 Inform disability evaluations in people who can and choose to have a CPET
👉 Improve precision in rehabilitation and treatment trials
We’re grateful to our participants. Their generous engagement continues to advance our understanding of these terribly disabling yet largely ignored chronic conditions.
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