CardioSomaticsCardioSomaticsCardioСоматика2221-71852658-5707Eco-Vector67689010.17816/CS676890WQHNUCReviewsОбзорыReview ArticleFeatures of diagnosing postexertional malaise and chronic fatigue syndrome in the development of medical rehabilitation programs for long COVIDОсобенности диагностики постнагрузочного недомогания и синдрома хронической усталости в разработке программ медицинской реабилитации «длительного COVID»https://orcid.org/0000-0002-2134-41078239-3942AvdeevaKsenia S.АвдееваКсения Сергеевна
Russian Federation

Tyumen Cardiology Research Center, MD, Cand. Sci. (Medicine)

Тюменский кардиологический научный центр, канд. мед. наук

avdeeva_03@mail.ruhttps://orcid.org/0000-0001-6251-41795896-5350PetelinaTatiana I.ПетелинаТатьяна Ивановна
Russian Federation

Tyumen Cardiology Research Center, MD, Dr. Sci. (Medicine), Assistant Professor

Тюменский кардиологический научный центр, д-р мед. наук, доцент

petelina@infarkta.nethttps://orcid.org/0009-0001-4898-60898833-7493GorbachevskiiAleksandr V.ГорбачевскийАлександр Владимирович
Russian Federation

Tyumen Cardiology Research Center

Тюменский кардиологический научный центр

gorbachevskyalex@mail.ruhttps://orcid.org/0000-0002-8155-37797785-7911SharoyanYliya A.ШароянЮлия Андреевна
Russian Federation

Tyumen Cardiology Research Center

Тюменский кардиологический научный центр

SharoyanUA@infarkta.nethttps://orcid.org/0000-0002-6446-52244653-9489BessonovaMarina I.БессоноваМарина Игоревна
Russian Federation

Tyumen Cardiology Research Center, MD, Cand. Sci. (Medicine)

Тюменский кардиологический научный центр, канд. мед. наук

bessonovami@infarkta.netTomsk National Research Medical Center of the Russian Academy of SciencesТомский национальный исследовательский медицинский центр Российской академии наук13072025110620251621561670603202522062025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, ООО "Эко-Вектор"2025Eco-VectorООО "Эко-Вектор"https://creativecommons.org/licenses/by-nc-nd/4.0https://cardiosomatics.ru/2221-7185/article/view/676890

One of the key challenges in modern medical rehabilitation is the recovery of patients with symptoms of long COVID. Various types of physical exercise are considered the most effective rehabilitation methods. However, according to published data, there is a phenotype of long COVID associated with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), characterized by postexertional malaise and exercise intolerance. For safe medical rehabilitation, early identification of ME/CFS and the development of alternative rehabilitation programs with reduced physical exertion are required for this category of patients.

Sources were identified through searches of electronic databases, including eLIBRARY.RU, SpringerLink, Frontiers, and PubMed.

The clinical importance of this issue is compounded by the absence of clear diagnostic criteria and validated biomarkers for both long COVID and ME/CFS, highlighting the need for thorough phenotyping. The present review provides a detailed description of the ME/CFS phenotype and proposes a diagnostic algorithm for postexertional malaise based on the use of questionnaires, diagnostic testing, and cardiopulmonary exercise testing in patients with long COVID.

Одна из важных проблем современной медицинской реабилитации — восстановление пациентов с симптомами «длительного COVID». Наиболее эффективными методами реабилитации считаются различные виды физических упражнений. Однако, согласно данным литературы, существует фенотип «длительного COVID» с синдромом хронической усталости (СХУ), который характеризуется ухудшением состояния после физической активности и непереносимостью физической нагрузки. В целях безопасности медицинской реабилитации необходима ранняя диагностика СХУ и формирование альтернативной программы реабилитации с ограничением физической нагрузки у этой категории пациентов.

Поиск и отбор литературных источников проводили в системе опубликованных исследований в научных базах elibrary.ru, link.springer.com, frontiersin.org, pubmed.ncbi.nlm.nih.gov и других.

Важность проблемы усугубляется тем, что у «длительного COVID» и СХУ отсутствуют чёткие диагностические критерии и специфические биомаркёры, что делает необходимым тщательный анализ фенотипов данных заболеваний. Результат анализа литературы по этой тематике — детальное описание фенотипа СХУ, а также попытка создания оптимального алгоритма диагностики постнагрузочного недомогания с использованием диагностических тестов, опросников и кардиопульмонального нагрузочного тестирования у пациентов с «длительным COVID».

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