Publication date: Jul 07, 2026
Post-COVID syndrome (PCS) is characterized by persistent heterogeneous symptoms after SARS-CoV-2 infection, yet objective biomarkers for symptom severity and longitudinal disease trajectories remain limited. We aimed to characterize muscle function over time in PCS and examine its relationship with symptom burden and neuroaxonal injury markers. In this prospective observational study, patients fulfilling WHO criteria for PCS underwent standardized assessments at baseline (BL) and six-month follow-up (FU). Muscle function was assessed using a multidimensional handgrip strength (HGS) protocol capturing mean force (Fmean), fatigability (fatigue ratio), and recovery capacity alongside clinical symptom measures. Analyses included longitudinal assessment within the PCS cohort, comparisons with COVID-19 recovered controls, analysis of symptom persistence, and matched cohort analyses including HGS measures and circulating neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP). Among 204 participants (102 PCS, 102 recovered controls) PCS patients showed lower Fmean and higher fatigability at BL and FU (both p
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| Concepts | Keywords |
|---|---|
| Biomarkers | Fatigability |
| Fatigue | GFAP |
| Handgrip | Handgrip strength |
| Month | Long COVID |
| Nfl | Longitudinal study |
| Muscle impairment | |
| Neurofilament light chain | |
| Post-COVID syndrome |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | syndrome |
| disease | MESH | PCS |
| disease | MESH | SARS-CoV-2 infection |
| pathway | REACTOME | SARS-CoV-2 Infection |
| disease | MESH | injury |
| disease | MESH | fatigue |
| disease | MESH | included |
| disease | MESH | Long Covid |
| pathway | REACTOME | Reproduction |
| disease | MESH | Infection |
| disease | MESH | muscle weakness |
| disease | MESH | small fiber neuropathy |
| disease | MESH | inflammation |
| disease | MESH | cognitive impairment |
| drug | DRUGBANK | 5-amino-1 3 4-thiadiazole-2-thiol |
| drug | DRUGBANK | Isoxaflutole |
| disease | MESH | SMDs |
| disease | MESH | obesity |
| disease | MESH | hypertension |
| disease | MESH | hypercholesterolemia |
| disease | MESH | FSS |