Introduction
myocarditis, fatigue
MYOCARDITIS, SARS-COV-2 INFECTION
Subsequent to the health problems of the acute phase of SARS-CoV-2 infection, the long-term consequences of SARS-CoV-2 infection are affecting large numbers of patients worldwide. Estimates of patients affected by persisting or new symptoms post-COVID reach from 6 to 28 percent of the infected population [The molecular mechanisms causing the symptoms post-COVID are not completely understood and are likely multi-factorial. A summary of these mechanisms is depicted in Supplemental Fig. 1. Physical exercise is well established to exert anti-inflammatory, vasculo-protective, and anti-aging effects [Based on the potential mechanisms contributing to the persisting symptoms post-COVID and the potential effects of physical exercise on these pathologies we hypothesized that physical training may be associated with beneficial effects for patients with persisting symptoms post-COVID. However, in addition to the assessment of potentially positive effects, it is important to establish the safety of exercise post-COVID. Physical exercise has negative effects in mice with myocarditis [We, therefore, performed a systematic search of the literature for training studies in patients post-COVID to review the available information on the safety and efficacy of physical exercise for these patients. The systematic review of the literature revealed a shortage of prospective, randomized training studies and a lack of information on safety. Therefore, we designed and performed a prospective study to test the effects of supervised personalized strength endurance training for 4 weeks or usual care on safety, fatigue, and quality of life.