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The Human Phenotype Ontology (HPO) is downloaded weekly from The file downloaded is considered the "last stable build" available for the ontology. For more about the HPO, view their website at

Term:Postexertional symptom exacerbation
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Accession:HP:0030973 term browser browse the term
Definition:Post-exertional symptom exacerbation (PESE), also referred to as post-exertional malaise (PEM), is defined as the worsening of symptoms that can follow minimal cognitive, physical, emotional, or social activity, or activity that could previously be tolerated. Symptoms typically worsen 12 to 72 hours after activity and can last for days or even weeks, sometimes leading to a relapse.
Comment:PEM can be observed in individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), as a post-acute sequela of SARS-CoV-2 infection (long COVID), and occasionally in individuals with mitochondrial disorders or cancer related fatigue. It is often accompanied by exacerabtion or new onset of exhaustion, cognitive impairment, muscle pain, muscle weakness, or other manifestations. The onset of PEM may occur hours or even days after exertion, and recovery from PEM is often slow, taking place over days or weeks or longer. PESE can contribute to the episodic nature of disability in post COVID-19 condition, often presenting as unpredictable fluctuations in symptoms and function.
Synonyms:exact_synonym: Exercise-induced malaise;   Postexertional malaise

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  Human phenotype 0
    Phenotypic abnormality 0
      Constitutional symptom 0
        Exercise intolerance 0
          Postexertional symptom exacerbation 0
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