Prevalence and Functional Outcomes of Post-Exertional Malaise among Adults with prior COVID-19: Results from a Representative Survey of New York City Residents
- 1New York City Department of Health and Mental Hygiene
Abstract
ObjectiveTo estimate the prevalence of Post-Exertional Malaise (PEM) among adults with prior COVID-19 and associated mental health and disability outcomes.
MethodsWe conducted a cross-sectional analysis of data from a survey of 9,620 adults with prior COVID-19 in New York City, collected May - June 2024. PEM was measured with the DePaul Symptom Questionnaire - Post Exertional Malaise, categorized by symptom duration (< 14 vs. [≥]14 hours). Weighted prevalence estimates were stratified by socio-demographic and clinical characteristics. Modified Poisson regression was used to assess the association of PEM with depression, anxiety, and disability.
ResultsThe prevalence of PEM symptoms was 20.9% overall and 4.0% with symptom duration [≥] 14 hours, representing over 800,000 New Yorkers affected and over 150,000 who meet a diagnostic criterion for ME/CFS. PEM prevalence was higher among women, transgender and non-binary adults, people of color, and lower educational attainment, chronic comorbidities, or disabilities. PEM was associated with 3 - 4 times higher prevalence of mental health outcomes and 4 - 5 times higher disability scores.
ConclusionsPEM symptoms were common and strongly associated with disability and adverse mental health. Screening, pathways to care, and supportive policies are needed to mitigate long-term consequences, particularly among marginalized populations.
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BibTeX
@misc{packard2026prevalence,
title = {{Prevalence and Functional Outcomes of Post-Exertional Malaise among Adults with prior COVID-19: Results from a Representative Survey of New York City Residents}},
author = {S. E. Packard and T. Russo and J. Parrott and J. Sisti and A. Lans},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.31.26356614},
url = {https://www.medrxiv.org/content/10.64898/2026.08.31.26356614v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Prevalence and Functional Outcomes of Post-Exertional Malaise among Adults with prior COVID-19: Results from a Representative Survey of New York City Residents
AU - S. E. Packard
AU - T. Russo
AU - J. Parrott
AU - J. Sisti
AU - A. Lans
PY - 2026
DA - 2026/08/31
PB - medRxiv
DO - 10.64898/2026.08.31.26356614
UR - https://www.medrxiv.org/content/10.64898/2026.08.31.26356614v1
AB - ObjectiveTo estimate the prevalence of Post-Exertional Malaise (PEM) among adults with prior COVID-19 and associated mental health and disability outcomes. MethodsWe conducted a cross-sectional analysis of data from a survey of 9,620 adults with prior COVID-19 in New York City, collected May - June 2024. PEM was measured with the DePaul Symptom Questionnaire - Post Exertional Malaise, categorized by symptom duration (< 14 vs. [≥]14 hours). Weighted prevalence estimates were stratified by socio-demographic and clinical characteristics. Modified Poisson regression was used to assess the association of PEM with depression, anxiety, and disability. ResultsThe prevalence of PEM symptoms was 20.9% overall and 4.0% with symptom duration [≥] 14 hours, representing over 800,000 New Yorkers affected and over 150,000 who meet a diagnostic criterion for ME/CFS. PEM prevalence was higher among women, transgender and non-binary adults, people of color, and lower educational attainment, chronic comorbidities, or disabilities. PEM was associated with 3 - 4 times higher prevalence of mental health outcomes and 4 - 5 times higher disability scores. ConclusionsPEM symptoms were common and strongly associated with disability and adverse mental health. Screening, pathways to care, and supportive policies are needed to mitigate long-term consequences, particularly among marginalized populations.
ER -