 Comments on: Physical activity and long COVID fatigue Eur J Transl Myol 33 (3) 11722, 2023 doi: 10.4081/ejtm.2023.11722 - 1 - Comments on: Effect of physical activity on long COVID fatigue Hinpetch Daungsupawong (1), Viroj Wiwanitkit (2,3) (1) Private Academic Consultant, Phonhong, Lao People's Democratic Republic; (2) Department of Pharmaceutical Sciences, Chandigarh University, Gharuan, Mohali, Punjab, India; (3) Joesph Ayobabalola University, Ikeji-Arakeji, Nigeria. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (CC BY-NC 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. Abstract This correspondence discusses a published article on the effects of physical activity on Long COVID fatigue. Confounding factors are possible and should be acknowledged. When managing Long COVID-19 fatigue, you need to worry about other possible causes of the problem. Key Words: Effect; physical activity; long COVID; fatigue. Eur J Transl Myol 33 (3) 11722, 2023 doi: 10.4081/ejtm.2023.11722 Dear Editor, we would like to share ideas on the publication “Effect of physical activity on long COVID fatigue: an unsolved enigma”.1 According to the study, long COVID, a syndrome characterized by chronic fatigue and muscle complaints beyond the initial phase, may be related with muscle atrophy or acute sarcopenia. Physical activity programs, according to the researchers, could help reverse the underlying muscle atrophy and ease weariness in long COVID patients. According to published studies, physically active patients with long COVID have shorter duration and less intensity of symptoms. However, the study found that a tiny minority of people with long-COVID may not benefit from physical activity regimens. As a result, the authors conclude that more research with homogeneous samples is required to provide stronger conclusions about the scheduled physical activity in the management of long COVID. The absence of substantial research on the usefulness of physical activity programs in treating long COVID is the statement's weak aspect. While few published articles imply that physical activity can reduce the length and intensity of long COVID symptoms, there is also evidence that these programs do not assist all patients. This suggests that more research on homogeneous populations is needed to provide conclusive response on usefulness of planned physical exercise in long COVID management. The following elements may affect the findings and make it more challenging to reach firm conclusions. A medical condition requires specific treatment for long COVID. In addition to the broad issues discussed, there are significant issues that should be recognized. i) While a positive COVID test may support a patient's clinical diagnosis, there is the possibility of undiagnosed comorbid diseases. Additionally, the patient may suffer from a second COVID-19 infection.2 ii) All prior vaccinations must be covered by the most current dose. iii) There must be enough information to establish how the disease influences health problems. List of acronyms COVID - coronavirus disease Contributions of Authors HD, 50 % ideas, writing, analyzing, approval; VW, 50 % ideas, supervision, approval. The authors read and approved the final edited manuscript. Acknowledgments None. Funding None. Conflict of Interest None. Ethical Publication Statement We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. Corresponding Author Hinpetch Daungsupawong, Private Academic Consultant, Phonhong, Lao People's Democratic Republic. ORCID iD: 0009-0002-5881-2709 Email: hinpetchdaung@gmail.com E-mail and ORCID iD of co-author Viroj Wiwanitkit: wviroj@yahoo.com ORCID iD: 0000-0003-1039-3728 mailto:hinpetchdaung@gmail.com mailto:wviroj@yahoo.com mailto:mcossio1972@hotmail.com Comments on: Physical activity and long COVID fatigue Eur J Transl Myol 33 (3) 11722, 2023 doi: 10.4081/ejtm.2023.11722 - 2 - References 1. Coscia F, Di Filippo ES, Gigliotti PV, Fano Illic G. Effect of physical activity on long COVID fatigue: an unsolved enigma. Eur J Transl Myol. 2023 Sep 4. doi: 10.4081/ejtm.2023.11639. Online ahead of print. PMID: 37667865. 2. Haq ZU, Fazid S, Yousafzai YM, Noor M, Ibrahimzai AK, Iqbal A, Ullah N, Sherin A. Repeated Covid-19 Infection Exists: A Case Series From Pakistan. J Ayub Med Coll Abbottabad. 2021 Jul-Sep;33(3):519-522. PMID: 34487669. Disclaimer All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Submission: September 5, 2023 Accepted for publication: September 6, 2023