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F. Authier 1 2, M. Aoun Sebaiti 1, S. Souvannanorath 1 2, E. Malfatti 1 2, E. Itti 1 2, G. Severa 1 21Paris Est Creteil University, Créteil, France2Henri Mondor University Hospital, Créteil, France
Available online 3 October 2025, Version of Record 3 October 2025.
https://doi.org/10.1016/j.nmd.2025.105492Get rights and content
Post-acute COVID-19 syndrome (PACS) is a highly multifaceted condition, mimicking myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in patients with the most prolonged evolution.
Due to the frequency of muscle pain and exertion intolerance, these patients are often suspected of having a muscular disease.
Here we present the results of the neuromuscular evaluation of patients with a clinically defined PACS.
Twenty-two consecutive PACS patients (17F, 5M; median age 47 yrs) were included.
All had at least one Covid-infection, confirmed by PCR, with mild respiratory symptoms, only one having required hospitalization and transfer to intensive care unit at acute stage.
After a variable period between weeks to few months, patients developed chronic fatigue (duration > 6 months; n=22, 100%), post-exertional malaise (n=22, 100%), cognitive impairment including short-term memory loss or “brain fog” (n=22, 100%), muscle pain (n=18, 82%).
No other specific neuromuscular clinical sign were found.
100% of patients fulfilled diagnostic criteria for ME/CSF: CDC1994/Fukuda, International Consensus Criteria 2011, US Inst Medicine 2015, UK National Institute for health and Care Excellence, 2021.
Nineteen (86%) didn’t show any recovery period after the onset of symptoms.
ENMG examination was normal, without myogenic pattern; CK levels were normal; and muscle MRI available in five patients did not present any changes including fibro-fatty replacement.
Brain 18FDG -PET/MRI showed a pattern of hypometabolism compatible with ME/CSF in half of patients.
Muscle biopsy was performed in 3 patients and disclosed mild myopathic features in 2/3.
In conclusion, our long-lasting PACS patients with muscular symptoms fulfilled criteria for ME/CSF and may present myopathological changes at muscle biopsy.
Neuromuscular Disorders
Volume 53, Supplement, September 2025, 10549229PMyological evaluation of patients with post-acute COVID-19 syndrome
F. Authier 1 2, M. Aoun Sebaiti 1, S. Souvannanorath 1 2, E. Malfatti 1 2, E. Itti 1 2, G. Severa 1 21Paris Est Creteil University, Créteil, France2Henri Mondor University Hospital, Créteil, France
Available online 3 October 2025, Version of Record 3 October 2025.
https://doi.org/10.1016/j.nmd.2025.105492Get rights and content
Post-acute COVID-19 syndrome (PACS) is a highly multifaceted condition, mimicking myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in patients with the most prolonged evolution.
Due to the frequency of muscle pain and exertion intolerance, these patients are often suspected of having a muscular disease.
Here we present the results of the neuromuscular evaluation of patients with a clinically defined PACS.
Twenty-two consecutive PACS patients (17F, 5M; median age 47 yrs) were included.
All had at least one Covid-infection, confirmed by PCR, with mild respiratory symptoms, only one having required hospitalization and transfer to intensive care unit at acute stage.
After a variable period between weeks to few months, patients developed chronic fatigue (duration > 6 months; n=22, 100%), post-exertional malaise (n=22, 100%), cognitive impairment including short-term memory loss or “brain fog” (n=22, 100%), muscle pain (n=18, 82%).
No other specific neuromuscular clinical sign were found.
100% of patients fulfilled diagnostic criteria for ME/CSF: CDC1994/Fukuda, International Consensus Criteria 2011, US Inst Medicine 2015, UK National Institute for health and Care Excellence, 2021.
Nineteen (86%) didn’t show any recovery period after the onset of symptoms.
ENMG examination was normal, without myogenic pattern; CK levels were normal; and muscle MRI available in five patients did not present any changes including fibro-fatty replacement.
Brain 18FDG -PET/MRI showed a pattern of hypometabolism compatible with ME/CSF in half of patients.
Muscle biopsy was performed in 3 patients and disclosed mild myopathic features in 2/3.
In conclusion, our long-lasting PACS patients with muscular symptoms fulfilled criteria for ME/CSF and may present myopathological changes at muscle biopsy.
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