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This study aimed to describe the disease course in the first year and assess one-year outcomes, focusing on clinical recovery and health-related quality of life (HR-QoL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cohort study, we recruited hospitalized patients\u2009\u2265\u200916 years with confirmed TBE from hospitals in Norway\u2019s endemic area. A composite clinical score consisting of variables on symptoms and neurological findings was scored at baseline (during hospitalization), 3- and 12 months. HR-QoL at 12 months was measured using RAND 36-item short form health survey and compared to the Norwegian reference population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 93 patients included, clinical improvement from baseline to 3 months was 68%, increasing to 77% by 12 months. The proportion of patients with symptoms or neurological findings influencing daily life was 98% at baseline, 52% at 3 months, and 41% at 12 months. 14% required inpatient rehabilitation, and 4\/56 (7%) of active workers were on full-time sick leave at 12 months. Severe disease and comorbidities were linked to poorer outcomes. Most common symptoms influencing daily life at 12 months were fatigue (28%), concentration issues (13%) memory and sleep difficulties (12% each), while 8% had clinical findings where impaired balance and tremor dominated. Patients scored lower in physical health and social functioning regarding HR-QoL than reference population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most improvements occur during the first three months; however, 41% of patients experience ongoing complaints at 12 months, impacting HR-QoL regarding physical health. Severe disease and comorbidities correlate with poorer prognoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Project #2,296,959\n                      <jats:bold>\u2013<\/jats:bold>\n                      The NOrwegian Tick-borne Encephalitis Study \u2013 NOTES. An Observational Study on Clinical Features, Long-term Outcomes and Immune Characteristics \u2013 Cristin.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-025-05341-z","type":"journal-article","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T10:26:06Z","timestamp":1762597566000},"page":"567-579","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tick-borne encephalitis in Norway: A cohort study of clinical course and health-related quality of life at three- and twelve-month follow-up"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0707-8236","authenticated-orcid":false,"given":"Hilde","family":"Skudal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8566-7039","authenticated-orcid":false,"given":"Tore","family":"Stenstad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6918-4157","authenticated-orcid":false,"given":"\u00c5slaug Rudjord","family":"Lorentzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1633-5660","authenticated-orcid":false,"given":"Else","family":"Quist-Paulsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7322-9266","authenticated-orcid":false,"given":"Jens","family":"Egeland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6828-0609","authenticated-orcid":false,"given":"B\u00f8rre","family":"Fevang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7527-3487","authenticated-orcid":false,"given":"Keson","family":"Jaioun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5487-0616","authenticated-orcid":false,"given":"Malin","family":"Veje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3050-2373","authenticated-orcid":false,"given":"Bj\u00f8rn \u00c5sheim","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7357-6287","authenticated-orcid":false,"given":"Anne Marit","family":"Solheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1063-5985","authenticated-orcid":false,"given":"Hege","family":"Kersten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0104-9626","authenticated-orcid":false,"given":"Randi","family":"Eikeland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,8]]},"reference":[{"key":"5341_CR1","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.antiviral.2019.01.014","volume":"164","author":"D Ruzek","year":"2019","unstructured":"Ruzek D et al (2019) Tick-borne encephalitis in Europe and Russia: review of pathogenesis, clinical features, therapy, and vaccines. 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Approval was granted by the South-Eastern Regional Ethical Committee (Date 6\/10\/2020\/Study no 96505) and the Data Protection Office at all the participating centers.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The manuscript does not contain any one individual\u2019s data in any form.Competing interests","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"Author Malin Veje has received speaker and consultant honoraria from Pfizer and speaker honoraria from Bavarian Nordic. Author \u00c5slaug Rudjord Lorentzen received a minor grant from Sanofi in 2021. Author Randi Eikeland has received speaker and travel honoraria from Pfizer. The remaining authors have no relevant financial or non-financial interests to disclose.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}