Mclaughlin, Marie, Cerexhe, Luke, Macdonald, Eilidh et al. · The American journal of medicine · 2025 · DOI
Researchers surveyed 253 people living with long COVID in Scotland to understand which symptoms are most common and how severe they are. The most frequent symptoms were post-exertional malaise (when activity makes symptoms worse), extreme tiredness, and thinking problems. The study found that people living in areas with more deprivation experienced more symptoms, but factors like vaccination status and age did not significantly affect symptom patterns.
This study provides crucial national-level data on long COVID symptom patterns in Scotland, filling a gap in UK-specific epidemiological knowledge. The identification of post-exertional malaise as nearly universal in this population strengthens the case for PEM-centered clinical assessment and validates patient-reported experiences, supporting advocacy for appropriate diagnostic criteria and management approaches.
This cross-sectional study cannot establish causation or determine whether observed associations (e.g., deprivation and symptom severity) reflect direct causal mechanisms or confounding factors. The self-selected survey sample may not be fully representative of all people with long COVID in Scotland, and the exclusion of hospitalized patients limits generalizability to the full spectrum of post-COVID illness.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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