Nji, Miriam A M, Briones, Elizabeth M, Issa, Anindita et al. · BMC infectious diseases · 2025 · DOI
This study looked at 984 patients who visited specialized clinics for ongoing problems after COVID-19 infection. Patients commonly experienced shortness of breath, fatigue, post-exertional malaise (feeling much worse after activity), and brain fog. Most patients needed multiple medical visits and referrals to different specialists like lung, heart, and neurologists, showing that post-COVID illness is complex and requires coordinated care from many healthcare providers.
This study demonstrates that post-COVID illness shares significant clinical features with ME/CFS, including high rates of post-exertional malaise, fatigue, and cognitive dysfunction, validating the complexity of prolonged post-viral illness. The findings underscore the urgent need for multidisciplinary, coordinated care models and healthcare resource planning—lessons directly applicable to ME/CFS patient management and research priorities.
This study does not establish the cause of post-COVID symptoms or prove whether these represent a distinct syndrome from other post-viral illnesses. As a retrospective observational study without a control group, it cannot determine causation or identify which interventions are effective; it only documents the symptoms and care-seeking patterns of patients who attended these clinics, potentially missing less severely affected patients.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Nji, Miriam A M, Briones, Elizabeth M, Issa, Anindita, Tierney, Maureen, Bertolli, Jeanne, Barshikar, Surendra, et al. (2025). Medical complexity and healthcare utilization among patients attending three U.S. post-COVID clinics.. BMC infectious diseases. https://doi.org/10.1186/s12879-025-11424-1
BibTeX
@article{mecfsatlas-nji-2025-medical-complexity,
author = {Nji, Miriam A M and Briones, Elizabeth M and Issa, Anindita and Tierney, Maureen and Bertolli, Jeanne and Barshikar, Surendra and Unger, Elizabeth R and Wisnivesky, Juan and Vu, Quan and Quimby, David and Abrams, Joseph and Jagan, Nikhil and Manouchehripour, Sasha and Laguerre, Martin and Cope, Jennifer R},
title = {Medical complexity and healthcare utilization among patients attending three U.S. post-COVID clinics.},
journal = {BMC infectious diseases},
year = {2025},
doi = {10.1186/s12879-025-11424-1},
note = {PubMed: 41013344},
url = {https://www.mecfsatlas.com/evidence/nji-2025-medical-complexity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/nji-2025-medical-complexity
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