Zhang, Hui, Yang, Peng, Gu, Xiaoying et al. · The Lancet regional health. Western Pacific · 2025 · DOI
This study followed over 12,000 people in Beijing who had COVID-19 (Omicron variant) about one year earlier. Researchers found that roughly 8% still had long COVID symptoms, with fatigue and post-exertional malaise (feeling worse after activity) being the most common complaints. People who had been reinfected with COVID were at much higher risk of developing long COVID.
This large, well-characterized cohort provides robust epidemiological data on long COVID prevalence and phenotyping one year post-infection, including objective biomarkers (lung function, imaging) often absent from patient-reported surveys. The findings on post-exertional malaise, neurological symptom progression, and the dose-response relationship with reinfection have direct relevance for understanding ME/CFS-like presentations in post-viral populations.
As a cross-sectional study, it cannot establish causality or temporal precedence of specific symptoms; it also cannot determine whether observed physiological abnormalities (reduced muscle strength, lung function) are directly caused by viral infection or mediated by deconditioning, behavioral changes, or other confounders. The study does not compare long COVID to pre-infection baseline health status, limiting ability to attribute findings solely to the infection.
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
Zhang, Hui, Yang, Peng, Gu, Xiaoying, Sun, Ying, Zhang, Rongling, Zhang, Daitao, et al. (2025). Health outcomes one year after Omicron infection among 12,789 adults: a community-based cross-sectional study.. The Lancet regional health. Western Pacific. https://doi.org/10.1016/j.lanwpc.2025.101507
BibTeX
@article{mecfsatlas-zhang-2025-health-outcomes,
author = {Zhang, Hui and Yang, Peng and Gu, Xiaoying and Sun, Ying and Zhang, Rongling and Zhang, Daitao and Zhang, Jiaojiao and Wang, Yeming and Ma, Chunna and Liu, Min and Ma, Jiaxin and Li, Aili and Wang, Yingying and Ma, Xiao and Cui, Xiaojing and Wang, Yimin and Liu, Zhibo and Wang, Wei and Zheng, Zhi and Li, Yong and Wu, Jin and Wang, Quanyi and Cao, Bin},
title = {Health outcomes one year after Omicron infection among 12,789 adults: a community-based cross-sectional study.},
journal = {The Lancet regional health. Western Pacific},
year = {2025},
doi = {10.1016/j.lanwpc.2025.101507},
note = {PubMed: 40226780},
url = {https://www.mecfsatlas.com/evidence/zhang-2025-health-outcomes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/zhang-2025-health-outcomes
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