Comments on: Effect of physical activity on long COVID fatigue

The authors of the Comments on: Effect of physical activity on long COVID fatigue by Daungsupawong F. and Wiwanitkit V. (2023) have highlighted certain aspects of future research that need to be considered before any conclusions can be drawn regarding the effect of previous physical activity and/or fitness on the course of long-COVID. We can only agree with this need, although we hope that the effects of SARS-CoV-2 infection will become less and less burdensome to manage. As we hypothesise in the last part of the article by Coscia et al. (2023), we think it is crucial to identify the molecular mechanism underlying the atrophic effect (if any) of the described disease states, which could originate from a local inflammatory storm induced by Spike binding to the ACE-2 receptor in muscle. When studies on muscle from patients will be available in sufficient numbers, we will be able to try to answer the still open questions.