Features of diagnosing postexertional malaise and chronic fatigue syndrome in the development of medical rehabilitation programs for long COVID

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One of the key challenges in modern medical rehabilitation is the recovery of patients with symptoms of long COVID. Various types of physical exercise are considered the most effective rehabilitation methods. However, according to published data, there is a phenotype of long COVID associated with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), characterized by postexertional malaise and exercise intolerance. For safe medical rehabilitation, early identification of ME/CFS and the development of alternative rehabilitation programs with reduced physical exertion are required for this category of patients.

Sources were identified through searches of electronic databases, including eLIBRARY.RU, SpringerLink, Frontiers, and PubMed.

The clinical importance of this issue is compounded by the absence of clear diagnostic criteria and validated biomarkers for both long COVID and ME/CFS, highlighting the need for thorough phenotyping. The present review provides a detailed description of the ME/CFS phenotype and proposes a diagnostic algorithm for postexertional malaise based on the use of questionnaires, diagnostic testing, and cardiopulmonary exercise testing in patients with long COVID.

About the authors

Ksenia S. Avdeeva

Tomsk National Research Medical Center of the Russian Academy of Sciences

Author for correspondence.
Email: avdeeva_03@mail.ru
ORCID iD: 0000-0002-2134-4107
SPIN-code: 8239-3942

Tyumen Cardiology Research Center, MD, Cand. Sci. (Medicine)

Russian Federation, 111 Melnikaite st, Tyumen, 625026

Tatiana I. Petelina

Tomsk National Research Medical Center of the Russian Academy of Sciences

Email: petelina@infarkta.net
ORCID iD: 0000-0001-6251-4179
SPIN-code: 5896-5350

Tyumen Cardiology Research Center, MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Tomsk

Aleksandr V. Gorbachevskii

Tomsk National Research Medical Center of the Russian Academy of Sciences

Email: gorbachevskyalex@mail.ru
ORCID iD: 0009-0001-4898-6089
SPIN-code: 8833-7493

Tyumen Cardiology Research Center

Russian Federation, Tomsk

Yliya A. Sharoyan

Tomsk National Research Medical Center of the Russian Academy of Sciences

Email: SharoyanUA@infarkta.net
ORCID iD: 0000-0002-8155-3779
SPIN-code: 7785-7911

Tyumen Cardiology Research Center

Russian Federation, Tomsk

Marina I. Bessonova

Tomsk National Research Medical Center of the Russian Academy of Sciences

Email: bessonovami@infarkta.net
ORCID iD: 0000-0002-6446-5224
SPIN-code: 4653-9489

Tyumen Cardiology Research Center, MD, Cand. Sci. (Medicine)

Russian Federation, Tomsk

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