AHS professor leads new research on long COVID
Introduction
For some people, the effects of COVID-19 don’t end when the infection clears. Months or even years later, routine activities like standing for long periods, socializing with friends or completing a normal day of work can leave them exhausted.
A research team co-led by KN and RS professor Robert Motl is investigating why. The study focuses on a long COVID symptom known as post-exertional malaise, which causes people to experience severe fatigue after activity that previously would not have posed a problem. Other UIC researchers leading the project include the College of Medicine’s Charles Abrams, professor of neurology and rehabilitation, and Jalees Rehman, professor of biochemistry and molecular genetics.
The study is part of the National Institutes of Health’s RECOVER initiative, a nationwide effort to better understand the long-term effects of COVID-19. Researchers are recruiting people with long COVID who experience post-exertional malaise or brain fog and people who have recovered from COVID without lasting symptoms.
Post-exertional malaise is one of long COVID’s most common symptoms, occurring in an estimated one-third to one-half of long COVID patients, Motl said.
“We’ve talked to people who, before they had COVID, were marathon runners who had active careers and families,” Motl said. “They got sick with COVID; it turned into long COVID with post-exertional malaise, and they’ve had to resign from their jobs. They’ve had to move in with family members and receive significant assistance with childcare and daily responsibilities.”
One person living with long COVID is Chicago resident John Smith, a university professor who first noticed symptoms after a COVID infection he contracted in 2021. The condition has affected his ability to perform ordinary activities.
“I wasn’t able to engage as much, and after regular activities, I would be exhausted and just kind of wiped out for the next day, or even sometimes a little bit longer,” he said.
The fatigue could be unpredictable and debilitating. “It’s really spotty,” Smith said. Simple get-togethers with friends and family could require significant rest afterward.
Looking for answers in blood vessels and muscle
The UIC researchers suspect that post-exertional malaise may stem from problems in the body’s vascular system. They are investigating whether an altered immune response following COVID-19 infection may disrupt blood flow to large muscles, like those in the legs. Reduced blood flow could force muscles to rely on less efficient energy-producing pathways, contributing to exhaustion and exercise intolerance.
“We think that there’s something about the immune response that has changed the way the vascular system is working,” Motl said.
To examine that possibility, study participants undergo an exercise test on a stationary bicycle. Researchers gradually increase resistance until participants reach their highest possible level of exertion. The goal is to measure exercise tolerance and to trigger a mild post-exertional malaise episode that can be studied in real time. Researchers monitor participants’ movement, sleep patterns, fatigue and energy levels using wearable sensors.
The team is also collecting blood samples in search of signs that might reveal what’s happening inside the muscles. The team will also examine RNA, DNA and other metabolic indicators associated with muscle function.
If successful, the study could provide one of the clearest pictures yet of what’s driving post-exertional malaise and offer clues for future treatments. Currently, there are no established therapies for the condition.
“We’re hoping that if we can identify that vascular dysfunction and blood flow to the muscle is the culprit, we might be able to start pointing toward interventions that could improve blood flow and help these individuals engage in meaningful life activities,” Motl said.
Advancing research for a misunderstood condition
Smith chose to participate in UIC’s study because of the uncertainty surrounding the origins of and treatments for long COVID. At first, he hoped to connect with others dealing with similar symptoms, but he also wanted to contribute to a growing body of research on a poorly understood condition.
“There’s a personal hope that maybe there would be some positive effect on my own life,” Smith said. “But also, just to contribute to the research and study to try to help other people who are going through long COVID.”
He believes research and specialized clinical care are both essential for people navigating long COVID.
“If people are experiencing the symptoms, I would recommend they connect with UIC,” Smith said, noting the value of having healthcare professionals who take long COVID seriously while actively studying it.
For Motl, the study represents an opportunity to bring scientific clarity to a problem that continues to affect millions of people.
“Hopefully we can shed some light on this in the public.”
This article was edited for clarity and length by Emily Parenti-Lopez.