Research & Literature

The evidence base for physiotherapy in myalgic encephalomyelitis/chronic fatigue syndrome when considering post-exertional malaise: a systematic review and narrative synthesis.

Wormgoor MEA, Rodenburg SC

Journal of translational medicine 2021; (19(1)):1 doi:10.1186/s12967-020-02683-4.

Modulatory effects of cognitive exertion on regional functional connectivity of the salience network in women with ME/CFS: A pilot study.

Manca R, Khan K, Mitolo M, et al.

Journal of the neurological sciences 2021; (422()):117326 doi:10.1016/j.jns.2021.117326.

Persistent Antiphospholipid Antibodies, Mast Cell Activation Syndrome, Postural Orthostatic Tachycardia Syndrome and Post-COVID Syndrome: 1 Year On.

Schofield JR

European journal of case reports in internal medicine 2021; (8(3)):002378 doi:10.12890/2021_002378.

The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 infection.

Moghimi N, Di Napoli M, Biller J, et al.

Current neurology and neuroscience reports 2021; (21(9)):44 doi:10.1007/s11910-021-01130-1.

Post-Acute COVID-19 Syndrome and the cardiovascular system: What is known?

Dixit NM, Churchill A, Nsair A, Hsu JJ

American heart journal plus : cardiology research and practice 2021; (5()):100025 doi:10.1016/j.ahjo.2021.100025.

Long-term SARS-CoV-2-specific immune and inflammatory responses in individuals recovering from COVID-19 with and without post-acute symptoms.

Peluso MJ, Deitchman AN, Torres L, et al.

Cell reports 2021; (36(6)):109518 doi:10.1016/j.celrep.2021.109518.

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Bisaccia G, Ricci F, Recce V, et al.

Journal of cardiovascular development and disease 2021; (8(11)) doi:10.3390/jcdd8110156.

Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection.

Mylvaganam RJ, Bailey JI, Sznajder JI, et al.

European respiratory review : an official journal of the European Respiratory Society 2021; (30(162)) doi:10.1183/16000617.0194-2021.

The Female-Predominant Persistent Immune Dysregulation of the Post-COVID Syndrome.

Ganesh R, Grach SL, Ghosh AK, et al.

Mayo Clinic proceedings 2022; (97(3)):454-464 doi:10.1016/j.mayocp.2021.11.033.

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications.

Kell DB, Laubscher GJ, Pretorius E

The Biochemical journal 2022; (479(4)):537-559 doi:10.1042/BCJ20220016.

Long-Term COVID 19 Sequelae in Adolescents: the Overlap with Orthostatic Intolerance and ME/CFS.

Morrow AK, Malone LA, Kokorelis C, et al.

Current pediatrics reports 2022; (10(2)):31-44 doi:10.1007/s40124-022-00261-4.

Post COVID fatigue: Can we really ignore it?

Sharma P, Bharti S, Garg I

The Indian journal of tuberculosis 2022; (69(2)):238-241 doi:10.1016/j.ijtb.2021.06.012.

Ongoing Dizziness Following Acute COVID-19 Infection: A Single Center Pediatric Case Series.

Drogalis-Kim D, Kramer C, Duran S

Pediatrics 2022; (150(2)) doi:10.1542/peds.2022-056860.

Cardiovascular symptom phenotypes of post-acute sequelae of SARS-CoV-2.

Mahmoud Z, East L, Gleva M, et al.

International journal of cardiology 2022; (366()):35-41 doi:10.1016/j.ijcard.2022.07.018.

Postural orthostatic tachycardia syndrome as a sequela of COVID-19.

Ormiston CK, Świątkiewicz I, Taub PR

Heart rhythm 2022; (19(11)):1880-1889 doi:10.1016/j.hrthm.2022.07.014.

Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches.

Ahamed J, Laurence J

The Journal of clinical investigation 2022; (132(15)).

A distinct symptom pattern emerges for COVID-19 long-haul: a nationwide study.

Pinto MD, Downs CA, Huang Y, et al.

Scientific reports 2022; (12(1)):15905 doi:10.1038/s41598-022-20214-7.

The other COVID-19 survivors: Timing, duration, and health impact of post-acute sequelae of SARS-CoV-2 infection.

Lambert N, , El-Azab SA, et al.

Journal of clinical nursing 2024; (33(1)):76-88 doi:10.1111/jocn.16541.

Case report: Treatment of long COVID with a SARS-CoV-2 antiviral and IL-6 blockade in a patient with rheumatoid arthritis and SARS-CoV-2 antigen persistence.

Visvabharathy L, Orban ZS, Koralnik IJ

Frontiers in medicine 2022; (9()):1003103 doi:10.3389/fmed.2022.1003103.

The effectiveness of activity pacing interventions for people with chronic fatigue syndrome: a systematic review and meta-analysis.

Casson S, Jones MD, Cassar J, et al.

Disability and rehabilitation 2023; (45(23)):3788-3802 doi:10.1080/09638288.2022.2135776.

Mindfulness Meditation Interventions for Long COVID: Biobehavioral Gene Expression and Neuroimmune Functioning.

Porter N, Jason LA

Neuropsychiatric disease and treatment 2022; (18()):2599-2626 doi:10.2147/NDT.S379653.

Tissue injury and leukocyte changes in post-acute sequelae of SARS-CoV-2: review of 2833 post-acute patient outcomes per immune dysregulation and microbial translocation in long COVID.

Islam MS, Wang Z, Abdel-Mohsen M, et al.

Journal of leukocyte biology 2023; (113(3)):236-254 doi:10.1093/jleuko/qiac001.

Post-exertional malaise among people with long COVID compared to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Vernon SD, Hartle M, Sullivan K, et al.

Work (Reading, Mass.) 2023; (74(4)):1179-1186 doi:10.3233/WOR-220581.

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC).

Sherif ZA, Gomez CR, Connors TJ, et al.

eLife 2023; (12()).

Thromboinflammation in long COVID-the elusive key to postinfection sequelae?

Nicolai L, Kaiser R, Stark K

Journal of thrombosis and haemostasis : JTH 2023; (21(8)):2020-2031 doi:10.1016/j.jtha.2023.04.039.

Multidisciplinary Center Care for Long COVID Syndrome-A Retrospective Cohort Study.

Bailey J, Lavelle B, Miller J, et al.

The American journal of medicine 2025; (138(1)):108-120 doi:10.1016/j.amjmed.2023.05.002.

Researching COVID to Enhance Recovery (RECOVER) adult study protocol: Rationale, objectives, and design.

Horwitz LI, Thaweethai T, Brosnahan SB, et al.

PloS one 2023; (18(6)):e0286297 doi:10.1371/journal.pone.0286297.

Considerations in Children and Adolescents Related to Coronavirus Disease 2019 (COVID-19).

Chen EY, Burton JM, Johnston A, et al.

Physical medicine and rehabilitation clinics of North America 2023; (34(3)):643-655 doi:10.1016/j.pmr.2023.03.004.

SARS-CoV-2 post-acute sequelae in previously hospitalised patients: systematic literature review and meta-analysis.

Kelly JD, Curteis T, Rawal A, et al.

European respiratory review : an official journal of the European Respiratory Society 2023; (32(169)) doi:10.1183/16000617.0254-2022.

Postural orthostatic tachycardia syndrome and other related dysautonomic disorders after SARS-CoV-2 infection and after COVID-19 messenger RNA vaccination.

Gómez-Moyano E, Rodríguez-Capitán J, Gaitán Román D, et al.

Frontiers in neurology 2023; (14()):1221518 doi:10.3389/fneur.2023.1221518.

Plasma proteomics show altered inflammatory and mitochondrial proteins in patients with neurologic symptoms of post-acute sequelae of SARS-CoV-2 infection.

Hanson BA, Visvabharathy L, Orban ZS, et al.

Brain, behavior, and immunity 2023; (114()):462-474 doi:10.1016/j.bbi.2023.08.022.

The importance of patient-partnered research in addressing long COVID: Takeaways for biomedical research study design from the RECOVER Initiative's Mechanistic Pathways taskforce.

Kim C, Chen B, Mohandas S, et al.

eLife 2023; (12()).

What Role Does Microthrombosis Play in Long COVID?

Iba T, Connors JM, Levy JH

Seminars in thrombosis and hemostasis 2024; (50(4)):527-536 doi:10.1055/s-0043-1774795.

Low-dose naltrexone use for the management of post-acute sequelae of COVID-19.

Bonilla H, Tian L, Marconi VC, et al.

International immunopharmacology 2023; (124(Pt B)):110966 doi:10.1016/j.intimp.2023.110966.

A scoping review of 'Pacing' for management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): lessons learned for the long COVID pandemic.

Sanal-Hayes NEM, Mclaughlin M, Hayes LD, et al.

Journal of translational medicine 2023; (21(1)):720 doi:10.1186/s12967-023-04587-5.

Long COVID and Wavering Incidence of Pulmonary Embolism: A Systematic Review.

Shah B, Ahmad MN, Khalid M, et al.

Journal of community hospital internal medicine perspectives 2023; (13(5)):23-31 doi:10.55729/2000-9666.1233.

Risk factors associated with post-acute sequelae of SARS-CoV-2: an N3C and NIH RECOVER study.

Hill EL, Mehta HB, Sharma S, et al.

BMC public health 2023; (23(1)):2103 doi:10.1186/s12889-023-16916-w.

Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection.

Chen C, Parthasarathy S, Leung JM, et al.

Frontiers in medicine 2023; (10()):1227883 doi:10.3389/fmed.2023.1227883.

Beyond the acute illness: Exploring long COVID and its impact on multiple organ systems.

Bhattacharjee N, Sarkar P, Sarkar T

Physiology international 2023; (110(4)):291-310 doi:10.1556/2060.2023.00256.

Intrinsic factors behind long COVID: III. Persistence of SARS-CoV-2 and its components.

El-Baky NA, Amara AA, Uversky VN, Redwan EM

Journal of cellular biochemistry 2024; (125(1)):22-44 doi:10.1002/jcb.30514.

Focus on post-exertional malaise when approaching ME/CFS in specialist healthcare improves satisfaction and reduces deterioration.

Wormgoor MEA, Rodenburg SC

Frontiers in neurology 2023; (14()):1247698 doi:10.3389/fneur.2023.1247698.

Post-COVID dysautonomias: what we know and (mainly) what we don't know.

Goldstein DS

Nature reviews. Neurology 2024; (20(2)):99-113 doi:10.1038/s41582-023-00917-9.

Low-dose Naltrexone Improves post-COVID-19 condition Symptoms.

Tamariz L, Bast E, Klimas N, Palacio A

Clinical therapeutics 2024; (46(3)):e101-e106 doi:10.1016/j.clinthera.2023.12.009.

Long COVID-19 and primary care: Challenges, management and recommendations.

Ahmed S, Ahmad E, Ahmad B, et al.

Semergen 2024; (50(3)):102188 doi:10.1016/j.semerg.2023.102188.

Longitudinal NMR-Based Metabolomics Study Reveals How Hospitalized COVID-19 Patients Recover: Evidence of Dyslipidemia and Energy Metabolism Dysregulation.

Ansone L, Rovite V, Brīvība M, et al.

International journal of molecular sciences 2024; (25(3)) doi:10.3390/ijms25031523.

Mixed methods system for the assessment of post-exertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome: an exploratory study.

Stussman B, Calco B, Norato G, et al.

BMJ neurology open 2024; (6(1)):e000529 doi:10.1136/bmjno-2023-000529.

Developing effective strategies to optimize physical activity and cardiorespiratory fitness in the long Covid population- The need for caution and objective assessment.

Faghy MA, Duncan R, Hume E, et al.

Progress in cardiovascular diseases 2024; (83()):62-70 doi:10.1016/j.pcad.2024.03.003.

The Aftermath of COVID-19: Exploring the Long-Term Effects on Organ Systems.

Golzardi M, Hromić-Jahjefendić A, Šutković J, et al.

Biomedicines 2024; (12(4)) doi:10.3390/biomedicines12040913.

Low-dose naltrexone for post-COVID fatigue syndrome: a study protocol for a double-blind, randomised trial in British Columbia.

Naik H, Cooke E, Boulter T, et al.

BMJ open 2024; (14(5)):e085272 doi:10.1136/bmjopen-2024-085272.

Long COVID incidence in adults and children between 2020 and 2023: a real-world data study from the RECOVER Initiative.

Mandel H, Yoo Y, Allen A, et al.

Research square 2024; doi:10.21203/rs.3.rs-4124710/v1.

Long-Term Impairment of Working Ability in Subjects under 60 Years of Age Hospitalised for COVID-19 at 2 Years of Follow-Up: A Cross-Sectional Study.

Frallonardo L, Ritacco AI, Amendolara A, et al.

Viruses 2024; (16(5)) doi:10.3390/v16050688.

Excess burden of respiratory and abdominal conditions following COVID-19 infections during the ancestral and Delta variant periods in the United States: An EHR-based cohort study from the RECOVER program.

Varma JK, Zang C, Carton TW, et al.

PloS one 2024; (19(6)):e0282451 doi:10.1371/journal.pone.0282451.

Nirmatrelvir-Ritonavir and Symptoms in Adults With Postacute Sequelae of SARS-CoV-2 Infection: The STOP-PASC Randomized Clinical Trial.

Geng LN, Bonilla H, Hedlin H, et al.

JAMA internal medicine 2024; (184(9)):1024-1034 doi:10.1001/jamainternmed.2024.2007.

Identification of risk factors of Long COVID and predictive modeling in the RECOVER EHR cohorts.

Zang C, Hou Y, Schenck EJ, et al.

Communications medicine 2024; (4(1)):130 doi:10.1038/s43856-024-00549-0.

Cognitive functioning in patients with neuro-PASC: the role of fatigue, mood, and hospitalization status.

Cahan J, Finley JA, Cotton E, et al.

Frontiers in neurology 2024; (15()):1401796 doi:10.3389/fneur.2024.1401796.

Early biological markers of post-acute sequelae of SARS-CoV-2 infection.

Lu S, Peluso MJ, Glidden DV, et al.

Nature communications 2024; (15(1)):7466 doi:10.1038/s41467-024-51893-7.

Long COVID or Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) and the Urgent Need to Identify Diagnostic Biomarkers and Risk Factors.

Parums DV

Medical science monitor : international medical journal of experimental and clinical research 2024; (30()):e946512 doi:10.12659/MSM.946512.

Sleep and long COVID: preexisting sleep issues and the risk of post-acute sequelae of SARS-CoV-2 infection in a large general population using 3 different model definitions.

Quan SF, Weaver MD, Czeisler MÉ, et al.

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2025; (21(2)):249-259 doi:10.5664/jcsm.11322.

Beyond Antivirals: Alternative Therapies for Long COVID.

Livieratos A, Gogos C, Akinosoglou K

Viruses 2024; (16(11)) doi:10.3390/v16111795.

Vaccination prior to SARS-CoV-2 infection does not affect the neurologic manifestations of long COVID.

Mukherjee S, Singer T, Venkatesh A, et al.

Brain communications 2025; (7(1)):fcae448 doi:10.1093/braincomms/fcae448.

Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement.

Cheng AL, Herman E, Abramoff B, et al.

PM & R : the journal of injury, function, and rehabilitation 2025; (17(6)):684-708 doi:10.1002/pmrj.13397.

Multidimensional Characterization of Long COVID Fatigue.

Maas MB, Reid KJ, Jimenez M, et al.

Behavioral sleep medicine 2025; (23(5)):675-684 doi:10.1080/15402002.2025.2522671.

Long COVID syndrome: exploring therapies for managing and overcoming persistent symptoms.

Chatterjee D, Maparu K

Inflammopharmacology 2025; (33(7)):4097-4113 doi:10.1007/s10787-025-01807-w.

Automatic detection of persistent physiological changes after COVID infection via wearable devices with potential for long COVID management.

Borhani S, Silva I, Damiano RJ, et al.

Scientific reports 2025; (15(1)):29443 doi:10.1038/s41598-025-15208-0.

Breathless Aftermath: Post-COVID-19 Pulmonary Fibrosis.

Muthiah D, Vaddadi K, Liu L

Viruses 2025; (17(8)) doi:10.3390/v17081098.

Persistent Immune Dysregulation during Post-Acute Sequelae of COVID-19 is Manifested in Antibodies Targeting Envelope and Nucleocapsid Proteins.

Kwissa M, Mathayan M, Salunkhe SS, et al.

bioRxiv : the preprint server for biology 2025; doi:10.1101/2025.08.18.670908.

Postexertional Symptom Exacerbation after Submaximal Exercise in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of COVID-19.

Berardi G, Janowski A, McNally S, et al.

Medicine and science in sports and exercise 2026; (58(4)):637-649 doi:10.1249/MSS.0000000000003891.

A Retrospective Observational Study of Pulmonary Impairments in Long COVID Patients.

Daodu LP, Raste Y, Allgrove JE, et al.

Biomedicines 2026; (14(1)) doi:10.3390/biomedicines14010145.

Clinical Characteristics of Patients Initially Suspected of Long COVID: A Case Series From a Specialized Outpatient Clinic.

Ohira M, Osada T, Kimura H, et al.

Journal of general and family medicine 2026; (27(1)):e70081 doi:10.1002/jgf2.70081.

Candidate treatments for long COVID: a narrative review of expert and patient-driven priorities.

Baptista SN, Atkins T, Chakraborty S, et al.

Frontiers in medicine 2026; (13()):1734600 doi:10.3389/fmed.2026.1734600.

Persistence of Post-Acute COVID-19 Sequelae (PASC) symptoms in healthcare workers four years after ancestral SARS-CoV-2 infection: a prospective multicentre cohort.

Saurer P, Ballouz T, Cusini A, et al.

Infection 2026; (54(3)):1407-1418 doi:10.1007/s15010-026-02768-0.

Can consumer wearables support outpatient health monitoring for patients with post-acute infection syndromes? A systematic umbrella review of accuracy, validity, and clinical utility data.

Kaplan DM, Kessler N, Pozzo NS, et al.

PLOS digital health 2026; (5(6)):e0001124 doi:10.1371/journal.pdig.0001124.

Rationale and Design of RECOVER-ENERGIZE: A Platform Clinical Trial of Interventions for Exercise Intolerance With and Without Post-exertional Malaise in Long COVID.

Friedly J, Bateman L, Berdan LG, et al.

medRxiv : the preprint server for health sciences 2026; doi:10.64898/2026.06.02.26354455.

The Use of a Handheld Non-Invasive Vagal Nerve Stimulation (nVNS) Device for the Treatment of Long COVID: A Pilot Randomized Controlled Trial.

Ganesh R, Yadav S, Schroeder DR, et al.

Journal of primary care & community health 2026; (17()):21501319261473073 doi:10.1177/21501319261473073.

Wearable Heart Rate Variability Monitoring, Autonomic Dysfunction and Post-exertional Malaise in Long COVID: An Observational Study.

Ruijgt TM, Slaghekke A, Ellens A, et al.

Sports medicine (Auckland, N.Z.) 2026; doi:10.1007/s40279-026-02487-4.

A cardiometabolic perspective on post-exertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID.

Westermeier F, Pretorius E, Untersmayr E, et al.

Cardiovascular diabetology 2026; (25(1)).