Shahzad, Maryam, Siddiqui, Sana, Lau, Chloe et al. · Healthcare (Basel, Switzerland) · 2026 · DOI
This study observed symptom burden, functional impairment, and mental health outcomes in 51 Canadian adults with long COVID who also identified as racialized and had pre-existing mental health conditions. Participants reported moderate overall symptoms, notable fatigue and post-exertional malaise, cognitive difficulties, and mild-to-moderate anxiety and depression, alongside moderate functional limitations in work, social, and daily activities. However, this is a small, self-selected group, and the findings may not generalise to all long COVID patients.
By analogy, this study documents the overlap between long COVID, mental health vulnerability, and functional impairment in a multiply-marginalised population. Similar intersectionality may apply to ME/CFS patients with pre-existing mental health conditions, where symptom burden and functional disability co-occur. However, relevance to ME/CFS is unclear, as long COVID and ME/CFS are distinct post-infectious syndromes, and the study does not explicitly differentiate long COVID from ME/CFS or compare outcomes.
This study does not establish causal relationships between racialized identity, mental health conditions, and long COVID severity. It does not compare outcomes to long COVID patients without pre-existing mental health conditions or to unaffected controls, so the attributable impact of comorbid mental health conditions remains unknown. The findings do not generalise beyond a self-selected Canadian cohort and should not be interpreted as representative of all long COVID patients or as applicable to ME/CFS without further evidence.
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
Shahzad, Maryam, Siddiqui, Sana, Lau, Chloe, Lamptey, De-Lawrence, Ezeugwu, Victor E, Maina, Geoffrey, et al. (2026). Symptom, Functional, and Work Participation Profiles Among Racialized Canadians with Pre-Existing Mental Health Challenges and Long COVID: A Cross-Sectional Study.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare14121726
BibTeX
@article{mecfsatlas-shahzad-2026-symptom-functional,
author = {Shahzad, Maryam and Siddiqui, Sana and Lau, Chloe and Lamptey, De-Lawrence and Ezeugwu, Victor E and Maina, Geoffrey and Maddison, Chris J and Flowers, Kimberly and Shah, Armaan Rehman and Welithotage, Thinuri and Nowrouzi-Kia, Behdin},
title = {Symptom, Functional, and Work Participation Profiles Among Racialized Canadians with Pre-Existing Mental Health Challenges and Long COVID: A Cross-Sectional Study.},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
doi = {10.3390/healthcare14121726},
note = {PubMed: 42354584},
url = {https://www.mecfsatlas.com/evidence/shahzad-2026-symptom-functional},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-07-08. https://www.mecfsatlas.com/evidence/shahzad-2026-symptom-functional
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