Feeling Tired After Walking: Causes and Implications of Long COVID Chronic Fatigue

Have you ever felt exhausted after taking a walk, even a short one? This phenomenon can be caused by several factors. Physical exertion, the intensity and duration of your walk, hydration, nutrition, sleep quality, and health conditions all play a role. However, research on long COVID has revealed that chronic fatigue can also be a symptom of post-acute coronavirus infection.

Common Causes of Feeling Tired After Walking

The physical body adjusts to the activity of walking, especially if you’re not used to it regularly. This can be tiring if your muscles are adapting. More intense or longer walks can lead to fatigue if you’re pushing yourself or walking at a fast pace. Dehydration can also cause fatigue, particularly if you haven’t had enough fluids before or during your walk. Nutritional deficiencies can affect energy levels, and if you haven’t eaten enough or your diet lacks balance, your body may lack the necessary fuel. Poor sleep can contribute to overall fatigue, making even mild exertion feel tiring.

Exploring Long COVID Chronic Fatigue

According to published medical papers on long COVID, chronic fatigue can be attributed to six conditions:

1. Persistent Tissue Damage and Autoimmunity

Coronavirus can cause persistent direct tissue damage and chronic inflammation. The novel coronavirus antigen can infect different organs, and each patient has a unique immune response. The tissue damage can lead to autoimmunity, as seen with autoreactive B lymphocytes remaining activated even after a negative PCR test. This long-term autoimmunity is one of the main causes of chronic fatigue.

2. Immune Escape and Trace Residual Viruses

With the emergence of more variants of the coronavirus and their stronger immune escape ability, the patient’s human leukocyte antigen (HLA) mismatch can lead to an immune system that cannot completely eliminate the virus. Some patients have residual novel coronavirus that continues to damage various organs and tissues, leading to a reduction in body function and fatigue.

3. Weakening of the Immune System

The coronavirus can destroy the immune system, making it less capable of fighting off other viruses. Epstein-Barr virus, cytomegalovirus, and herpes virus can reactivate and infect tissue cells, causing chronic inflammation and autoimmunity.

4. Dysregulated Cytokine Networks

In some patients, the coronavirus disrupts the cytokine network, leading to chronic inflammation. Pro-inflammatory substances like those triggered by systemic viral infections, such as NLRP3, HMGB1, and IL-6, may also contribute to post-acute COVID-19 chronic fatigue.

5. Cellular and Mitochondrial Damage

The coronavirus invades tissue cells, disrupting mitochondrial structure, cellular metabolism, and energy cycling. Mitochondrial enzymes are involved in inflammatory and oxidative reactions, leading to chronic fatigue.

6. Blood-Brain Barrier Breach and Neurological Symptoms

The virus can breach the blood-brain barrier and infect nerve cells in the brain. This can cause systemic malaise and affect neurotransmitter levels, leading to sleep disorders, anxiety, and chronic fatigue.

Long-Term Implications and Research

Most people with long COVID exhibit symptoms like brain fog, fatigue, and pain. Mady Hornig, a psychiatrist from Columbia University, has conducted influential research on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and has been instrumental in establishing ME/CFS as a biological disease. She believes that research on the overlap between ME/CFS and long COVID could help millions of people. Her findings revealed striking similarities between long COVID and ME/CFS, particularly in symptoms such as fatigue and sleep disturbances.

New research indicates that if a patient has a history of psychological diseases like insomnia, anxiety, or depression, they are more likely to suffer from chronic fatigue after contracting the novel coronavirus. Infection with the novel coronavirus can exacerbate these conditions.

Understanding these causes and implications is crucial for developing effective treatments and management strategies for patients dealing with both chronic fatigue and long-term effects of the coronavirus.