{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T22:31:34Z","timestamp":1792881094858,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF21OC0066984"],"award-info":[{"award-number":["NNF21OC0066984"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Among post\u2010COVID\u201019 symptoms, fatigue is reported as one of the most common, even after mild acute infection, and as the cause of fatigue, myopathy diagnosed by electromyography has been proposed in previous reports. This study aimed to explore the histopathological changes in patients with post\u2010COVID\u201019 fatigue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixteen patients (mean age\u00a0=\u00a046\u2009years) with post\u2010COVID\u201019 complaints of fatigue, myalgia, or weakness persisting for up to 14\u2009months were included. In all patients, quantitative electromyography and muscle biopsies analyzed with light and electron microscopy were taken.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Muscle weakness was present in 50% and myopathic electromyography in 75%, and in all patients there were histological changes. Muscle fiber atrophy was found in 38%, and 56% showed indications of fiber regeneration. Mitochondrial changes, comprising loss of cytochrome c oxidase activity, subsarcollemmal accumulation, and\/or abnormal cristae, were present in 62%. Inflammation was found in 62%, seen as T lymphocytes and\/or muscle fiber human leukocyte antigen ABC expression. In 75%, capillaries were affected, involving basal lamina and cells. In two patients, uncommon amounts of basal lamina were found, not only surrounding muscle fibers but also around nerves and capillaries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The wide variety of histological changes in this study suggests that skeletal muscles may be a major target of SARS\u2010CoV\u20102, causing muscular post\u2010COVID\u201019 symptoms. The mitochondrial changes, inflammation, and capillary injury in muscle biopsies can cause fatigue in part due to reduced energy supply. Because most patients had mild\u2013moderate acute affection, the new variants that might cause less severe acute disease could still have the ability to cause long\u2010term myopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.15435","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T03:24:59Z","timestamp":1654485899000},"page":"2832-2841","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":113,"title":["Myopathy as a cause of fatigue in long\u2010term\n                    <scp>post\u2010COVID<\/scp>\n                    \u201019 symptoms: Evidence of skeletal muscle histopathology"],"prefix":"10.1111","volume":"29","author":[{"given":"Eva K.","family":"Hejb\u00f8l","sequence":"first","affiliation":[{"name":"Department of Pathology Odense University Hospital  Odense Denmark"},{"name":"Department of Regional Health Research University of Southern Denmark  Odense 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