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In this narrative review, we discuss cellular and molecular pathways that are affected and consider these in regard to skeletal muscle involvement in other conditions, such as acute respiratory distress syndrome, critical illness myopathy, and post\u2010viral fatigue syndrome. Patients with severe Covid\u201019 and PASC suffer from skeletal muscle weakness and exercise intolerance. Histological sections present muscle fibre atrophy, metabolic alterations, and immune cell infiltration. Contributing factors to weakness and fatigue in patients with severe Covid\u201019 include systemic inflammation, disuse, hypoxaemia, and malnutrition. These factors also contribute to post\u2010intensive care unit (ICU) syndrome and ICU\u2010acquired weakness and likely explain a substantial part of Covid\u201019\u2010acquired weakness. The skeletal muscle weakness and exercise intolerance associated with PASC are more obscure. Direct severe acute respiratory syndrome coronavirus (SARS\u2010CoV)\u20102 viral infiltration into skeletal muscle or an aberrant immune system likely contribute. Similarities between skeletal muscle alterations in PASC and chronic fatigue syndrome deserve further study. Both SARS\u2010CoV\u20102\u2010specific factors and generic consequences of acute disease likely underlie the observed skeletal muscle alterations in both acute Covid\u201019 and PASC.<\/jats:p>","DOI":"10.1002\/jcsm.12896","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T07:47:02Z","timestamp":1641628022000},"page":"11-22","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":202,"title":["Skeletal muscle alterations in patients with acute Covid\u201019 and post\u2010acute sequelae of Covid\u201019"],"prefix":"10.1002","volume":"13","author":[{"given":"Madu N.","family":"Soares","sequence":"first","affiliation":[{"name":"Laboratory for Myology, Faculty of Behavioural and Movement Sciences Amsterdam Movement Sciences, Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4006-4063","authenticated-orcid":false,"given":"Moritz","family":"Eggelbusch","sequence":"additional","affiliation":[{"name":"Laboratory for Myology, Faculty of Behavioural and Movement Sciences Amsterdam Movement Sciences, Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Department of Nutrition and Dietetics Amsterdam UMC, Location VUmc, Amsterdam Movement Sciences Amsterdam The Netherlands"},{"name":"Faculty of Sports and Nutrition, Center of Expertise Urban Vitality Amsterdam University of Applied Sciences Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6212-1236","authenticated-orcid":false,"given":"Elie","family":"Naddaf","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin H. 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