Tomaskovic et al. (2026)
- Authors: Aleksandar Tomaskovic, Vincent Weber, David T Ochmann, Barlo Hillen, Elmo W I Neuberger, Alexandra Brahmer, Ella Lachtermann, Klaus Lieb, Perikles Simon
- Institutes: Department of Sports Medicine, Prevention and Rehabilitation, Institute for Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany, Institute for Occupational, Social and Environmental Medicine, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany, Clinic of Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
- Publisher: Sports Medicine - Open
- Link: DOI
Summary
This study demonstrates that cardiopulmonary exercise testing (CPET) can objectively quantify the severe physical limitations and work disability in patients with Post-COVID and ME/CFS. By finding a direct link between physiological metrics, such as peak oxygen uptake, and a patient’s occupational status, the research supports the use of objective testing to validate patient symptoms. These findings have significant implications for insurance and occupational health assessments, providing a measurable basis for work incapacity that standard clinical tests often miss.
What was researched?
The study investigated the use of cardiopulmonary exercise testing (CPET) to objectively assess physical work capacity and functional limitations in patients with severe post-COVID-19 condition (PCC) and ME/CFS.
Why was it researched?
Standard organ-centered diagnostics often fail to explain the profound work disability experienced by these patients, leading to a need for objective measures to support clinical and occupational evaluations.
How was it researched?
Researchers conducted symptom-limited CPET on 92 PCC patients with suspected occupational disease, evaluating them against ME/CFS diagnostic criteria, the Bell Disability Scale, and the DePaul Symptom Questionnaire for Post-Exertional Malaise.
What has been found?
Nearly half (49%) of the patients met the criteria for ME/CFS and exhibited significantly lower peak oxygen uptake (VO2 peak), peak power output (PPO), and oxygen pulse compared to those without ME/CFS. Overall, 66% of the cohort met objective thresholds for work disability, with the lowest physiological performance seen in those on medical sick leave.
Discussion
The study highlights that CPET reveals significant bioenergetic and functional impairments that correlate closely with patients’ subjective reports of disability. A limitation is the specific cohort of patients already seeking recognition for occupational disease, which may represent more severe cases.
Conclusion & Future Work
Severely affected post-viral patients exhibit objective work disability that is measurable via CPET, particularly those with ME/CFS. Integrating these tests into clinical evaluations can better inform individualized therapy and return-to-work decisions.