研究发现：长新冠会导致身体发生变化，从而使运动能力下降

概要

据调查，仅在英国就有约200万人患有长新冠，许多人在一次运动后症状会恶化数周。许多患有长新冠的人在运动后长时间感到疲倦、不适和疼痛。研究人员认为生物学变化是导致上述症状的罪魁祸首，如严重的肌肉损伤、线粒体问题和体内微血块的存在。

这项研究发表在《自然-通讯》杂志上，有25名感染长新冠的患者在运动后出现不适症状，还有21名感染新冠病毒但完全康复的患者参与了研究。每位参与者都在运动自行车上骑了约10-15分钟，并在任务前一周和任务后一天采集了血液样本和骨骼肌活检样本。虽然患者之间存在很大差异，但平均而言，长新冠患者的运动能力低于健康参与者。

研究人员对运动前提取的活检样本进行分析后发现，与健康参与者相比，长新冠患者肌肉中白色纤维的比例更高。研究小组还发现，有迹象表明，长新冠患者体内的线粒体不如健康参与者体内的线粒体运行得好。这些发现部分解释了为什么长新冠患者运动能力较低。

此外，长新冠患者的骨骼肌中有更多的淀粉样蛋白团块，但没有证据表明这些“微血块”会像一些研究人员之前提出的那样堵塞血管。

对骑车前后的活检结果进行比较后发现，长新冠患者在运动后线粒体的功能会恶化，这些参与者在运动后的组织损伤和身体试图修复的迹象要多得多。这可以解释这些患者在运动后出现的肌肉疼痛。总之，这些研究结果突出表明，患有长新冠的人不应该进行剧烈运动，否则会损害肌肉，使新陈代谢恶化。

Long Covid causes changes in body that make exercise debilitating – study

Experts say severe muscle damage, mitochondrial problems and microclots may explain impact of working out

Intense exercise can cause muscle damage and problems with mitochondria in people with long Covid. Photograph: FatCamera/Getty Images

Many people with long Covid feel tired, unwell and in pain for lengthy periods after exercise, and researchers say they now know why.

Experts say they have evidence that biological changes are to blame, such as severe muscle damage, mitochondrial problems and the presence of microclots in the body.

“It’s really confirming that there is something inside the body going wrong with the disease,” said Dr Rob Wüst, an author of the study at Vrije Universiteit (Free University) Amsterdam.

Long Covid is thought to affect about 2 million people in the UK alone, and many experience a worsening of symptoms for weeks after a single bout of exercise.

Published in the journal Nature Communications, the study involved 25 patients with long Covid who reported experiencing malaise after exercising, and 21 people who had had Covid but made a full recovery. None of the participants had been hospitalised with Covid, while all had been fit and healthy before catching the virus and were of working age.

Each participant spent about 10-15 minutes on an exercise bicycle, and blood samples and skeletal muscle biopsies were taken a week before and the day after the task.

While there was considerable variation between patients, on average, people with long Covid had a lower exercise capacity than healthy participants.

When the researchers analysed the biopsies taken before exercise, they found that those with long Covid had a greater proportion of white fibres in their muscles than healthy participants. These fibres have fewer power-producing structures, known as mitochondria, within their cells, and fewer capillaries.

The team also found signs that the mitochondria in people with long Covid did not work as well as those in healthy participants.

Wüst said the findings partly explained why people with long Covid had a lower capacity for exercise.

The team also found that people with long Covid had more clumps of a protein called amyloid in their skeletal muscles, although there was no evidence that these “microclots” were blocking blood vessels as some researchers have previously proposed.

Comparison of the biopsies taken before and after cycling revealed the function of the mitochondria worsened after exercise in those with long Covid, and these participants had far more tissue damage after exercising and signs of the body attempting repairs.

“That can explain, for instance, the muscle pain that these patients are experiencing after exercise,” said Wüst.

He said the findings highlighted that people with long Covid should not undertake intense exercise.

“It damages your muscles, it worsens your metabolism, and it can explain why you feel muscle pain and fatigue up to weeks after the exercise,” he said.

Prof Betty Raman, of the University of Oxford, who was not involved in the study, said her own research suggested that mitochondrial dysfunction might play a role in the fatigue that some people with long Covid experience. The latest study adds weight to the idea that treatments that improve mitochondrial health could be beneficial, she said.

But, Raman noted, this might not be the full story: “While it is plausible that fatigue is associated with these metabolic abnormalities, other contributing factors, such as persistent inflammation, may also play a role.”

Source:

The Guardian

Published on 4 January 2024

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