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In our paper, we investigated pain, myalgia, and fatigue as symptoms in long-COVID patients with an electrophysiological approach, comprising the evaluation of sympathetic skin responses (SSRs) and quantitative electromyography (qEMG).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>Twelve patients were enrolled (mean age, 47.7\u2009\u00b1\u200911.6\u00a0years), referred to our attention because of myalgia, pain, or muscle cramps, which persisted about 6\u00a0months after the diagnosis of SARS-CoV-2 infection. They underwent conventional electroneurography (ENG), needle electromyography (EMG), and SSRs; moreover, qEMG was performed by sampling at least 20 motor unit potentials (20\u201330 MUPs) during weak voluntary contraction in deltoid and tibialis anterior muscles. The mean duration, amplitude, and percentage of polyphasic potentials were assessed and compared with healthy and age-matched volunteers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>ENG did not disclose significant changes compared to healthy subjects; needle EMG did not reveal denervation activity. In addition, qEMG showed MUPs similar to those recorded in healthy volunteers in terms of polyphasia (deltoid: <jats:italic>p<\/jats:italic>\u2009=\u20090.24; TA: <jats:italic>p<\/jats:italic>\u2009=\u20090.35), MUP area (deltoid: <jats:italic>p<\/jats:italic>\u2009=\u20090.45; TA: <jats:italic>p<\/jats:italic>\u2009=\u20090.44), mean duration (deltoid: <jats:italic>p<\/jats:italic>\u2009=\u20090.06; TA: <jats:italic>p<\/jats:italic>\u2009=\u20090.45), and amplitude (deltoid: <jats:italic>p<\/jats:italic>\u2009=\u20090.27; TA: <jats:italic>p<\/jats:italic>\u2009=\u20090.63). SSRs were not recordable from lower limbs in seven patients (58%) and from the upper ones in three of them (25%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our data suggest an involvement of the autonomic system, with a focus on cholinergic efferent sympathetic activity, without any evidence of myopathic changes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10072-023-06637-8","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T08:03:57Z","timestamp":1675411437000},"page":"1147-1153","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Not myopathic, but autonomic changes in patients with long-COVID syndrome: a case series"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8874-1070","authenticated-orcid":false,"given":"Tommaso","family":"Bocci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Bertini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Campiglio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Botta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Libelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Guidetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Priori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"6637_CR1","doi-asserted-by":"publisher","first-page":"4486","DOI":"10.1007\/s00415-021-10604-8","volume":"268","author":"G Bulfamante","year":"2021","unstructured":"Bulfamante G, Bocci T, Falleni M et al (2021) Brainstem neuropathology in two cases of COVID-19: SARS-CoV-2 trafficking between brain and lung. 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