Trial By Error: Interview with Dr Rob Wüst about New Study of Muscle Abnormalities in Long Covid

By David Tuller, DrPH

In early January, Nature Communications published a Dutch study called “Muscle abnormalities worsen after post-exertional malaise in long COVID.” The study caused a buzz among patients, clinicians, and other researchers and generated extensive news coverage. Called. (I wrote a blog post about it here.) The investigators identified significant biological differences after an exercise challenge between long Covid patients with post-exertional malaise and matched healthy controls who had recovered from COVID-19. Earlier today, I spoke with Dr Rob Wüst, one of the main authors and an expert in muscle metabolism at Vrije [Free] University Amsterdam, about the implications of the findings, some questions raised on social media regarding deconditioning and normal post-exercise response, and related stuff. (I had more questions I would have liked to ask, but we had already gone past my standard 30-minute limit for interviews, and it was dinner-time in for Dr Wüst in Amsterdam.)

4 thoughts on “Trial By Error: Interview with Dr Rob Wüst about New Study of Muscle Abnormalities in Long Covid”

  1. A most interesting interview. Many thanks to Dr Wüst for taking the time to explain the muscle study and its findings and for doing that so well.

  2. Interesting Investigations . Covid Effected People Randomly . Long Covid also . People all over the World are now Living with Long Covid Disease . Which has similarites in ways and differers in others from person to person . Depending to some degree perhaps ? On Individuals pre existing weaknesses . Targets of the Virus .

    We are only just begining to find out . The extent of the Long Term Effects of Long Covid . On some of those varies Long Covid Symptoms ?!

    What the long-term effects of LC Muscle Damage could lead to ?

    I had pre existing Latent Muscle Damage Areas . Prior to contracting Covid19 in Mar 2020 . Respiritory Muscle Damage from 2006 . Pelvic Abdominal Muscle Damage from arround 1996 . Effects of Damage in Both Areas Improved Over Time .

    Covid 19 Effects within my Make up :
    Covid 19 Virus . Took my Breathing down upon onset . I had difficulty walking – difficulty lifting legs to walk . When Virus had presumable left my body 5 weeks later . I began the Long Covid Cycle in Me.

    Restricted Respiritory Function .
    Fluctuations in Walking Ability .
    Limited Exertion Tolerance .
    Weeks of Flat Lined Fatigue , followed Limited Exertion Levels .

    I was no longer able to daily commute on an ordinary Bicycle . I changed to an Ebike as a Mobility Aid .

    In the unknow Aftermath. I’d hoped Long Covid Symptoms in Me . Would eventualy fade away .

    The Cycle was Intense for 6 mths . No good days . Few steps forward . 12 back .

    Cycle Dropped down a notch over the next 6 mths to a year . With 1 or 2 good days . Followed by 2-3 weeks Flat Lined Exhaustion , Limited Mobility and Respiritory Decline .

    Cycle dropped down a few notches between April 23 – June 23 . Exertion levels noticably Improved . 3 – 4 good days . Followed by 7 Days Flat lined Fatigue , Limited Mobility and RD . For the 1st time I was hopeful .

    Cycle upped a few notches in June 23 . 1 good day . Followed by 2 – 3 weeks Flat lined Fatigue and Fluctuating Limited Mobility and RD .

    Durring August 23 . I endured regular neccessary Heavy Weight Bearing Activity . My Mobility steadily Decreased over the month. From 3 ten minute dog walks a day . To 2 to 1 to 1 every 3rd days . To a 5 minute walk every 3rd day to none .

    Cycle came back round to 2 – 3 good days in Sept 23 . Durring which . I walked up and down a steep hill 3 times in the one day . I was hopeful . My hope was dashed 1 to 2 days later. With the onset of Extreme Limited Mobility . I could barely lift my feet of the ground to walk . The next day I began to experience severe Dragging pain within the lower abdomin when attempting to walk . I could barely walk . The next day a Prolapse . The following Week Bladder Incontinence . The next Partial Bowl Incontenance . These Internal Organ Conditions receded with Hospital Bed Rest .

    It seemed something had gone very seriously wrong with my Abdominal Pelvic Muscle System . They were not sufficiently Supporting Walking Ability , the Internal Abdominal Organs or Respiritory Function .

    I have been left with severe Limited Mobility . Extreme Body Weakness and RD .
    Constant Horizontal Rest required . To minimise advancement of Muscle Conditions Impact . Specificaly , to Protect Vital Abdominal Pelvic Organs and their Functions . From Possible Irreversible Damage .

    There are times I feel I am having to support and hold up the contents of my Abdomin .

    The Perimiters of the LC Cycle had widened .

    Abdominal Pelvic Muscle Weakness . Means attempting to walk even a few steps . Leads to Severe Pain accross Lower Abdomin and Changes in Bladder Function . Attempting more than a few steps . Leads to pain and discomfort over the Whole Abdominal Muscle Area .

    I have been unable to leave my home in over 5 months . Ambulance Wheel Chair Lifts neccessary for Emergancy Hospital Admissions and Appointments.

    I have had a wrong suspected Diagnostic Opinion . A wrong Neuro Opinion . I still have no Proper Diagnosis .

    I face up to a year wait for a Gyno Appointment …

    In the Unknown Long Term Effects of Long Covid . Phisio to Strengthen the Abdominal Pelvic Muscles ? May do more Harm than Good .

    I face an Uncertain future . Within an Unknown Science .

    I’m the Cart before the Horse . I need a Team of Horses . To change that and maybe Fix me ?

  3. Thank you, Dr. Wust, for all your efforts seeking the underlying pathophysiology of these diseases. This is SO needed. I for one, an ME/CFS patient for over 30 years, am very grateful. Wishing you all the best in your future endeavors.

    Thanks also to Dr. Tuller for keeping on top of all of this.

  4. What a great interview and hope for the future. I wonder if there’s any dovetail here into the zone 2 training research by inigo San Millan. It seems zone 2 increases the number of functional mitochondria. Perhaps our zone 2 is WAY lower than normal if we suffer from PEMs but I wonder if it would help. More research please! And a heartfelt thanks

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