Abstract
Long COVID remains a public health challenge, impacting over 65 million people globally and manifesting as persistent, multisystemic symptoms that complicate both diagnosis and treatment. To address the need for a standardized, patient-centered assessment tool, this study introduces the Memorial Symptom Assessment Scale-Long COVID (MSAS-LC), which evaluates symptom prevalence, frequency, severity, and distress. The MSAS-LC was developed by modifying the Memorial Symptom Assessment Scale to include 45 prevalent Long COVID symptoms. A cross-sectional survey of 261 U.S. adults (129 with Long COVID and 131 without) assessed validity and group differences. Symptom prevalence was analyzed using logistic regression, while symptom burden (frequency, severity, and distress) was compared using generalized linear models. Participants with Long COVID reported significantly higher symptom prevalence and burden across all systems. Memory problems (73.4% vs. 30.5%; OR = 6.29, p < 0.001) and post-exertional fatigue (OR = 8.55, p < 0.001) were among the most burdensome symptoms. These findings offer preliminary evidence supporting the potential utility of MSAS-LC and underscore the continued public health relevance of individual and collective symptom presentations. The findings suggest the distinct symptom burden, emphasizing the importance of future research to inform diagnostic and treatment strategies. With continued validation, the MSAS-LC may contribute to improved symptom monitoring and care planning in clinical and public health settings.