• Phillip Joseph, Inderjit Singh, Rudolf Oliveira, Christine A Capone, Mary P Mullen, Dane B Cook, Mary Catherine Stovall, Johanna Squires, Kristine Madsen, Aaron B Waxman, and David M Systrom.
• Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Yale-New Haven Hospital, Yale University, New Haven, CT.
• Chest. 2023 Sep 1; 164 (3): 717726717-726.

Topic ImportancePostacute sequelae of SARS-CoV-2 (PASC) is a long-term consequence of acute infection from COVID-19. Clinical overlap between PASC and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has been observed, with shared symptoms including intractable fatigue, postexertional malaise, and orthostatic intolerance. The mechanistic underpinnings of such symptoms are poorly understood.Review FindingsEarly studies suggest deconditioning as the primary explanation for exertional intolerance in PASC. Cardiopulmonary exercise testing reveals perturbations related to systemic blood flow and ventilatory control associated with acute exercise intolerance in PASC, which are not typical of simple detraining. Hemodynamic and gas exchange derangements in PASC have substantial overlap with those observed with ME/CFS, suggestive of shared mechanisms.SummaryThis review illustrates exercise pathophysiologic commonalities between PASC and ME/CFS that will help guide future diagnostics and treatment.Copyright © 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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