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To clarify multisystem involvement, we undertook a prospective cohort study including patients who had been hospitalized with COVID-19 (ClinicalTrials.gov ID\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04403607\">NCT04403607<\/jats:ext-link>\n                      ). Serial blood biomarkers, digital electrocardiography and patient-reported outcome measures were obtained in-hospital and at 28\u201360\u2009days post-discharge when multisystem imaging using chest computed tomography with pulmonary and coronary angiography and cardio-renal magnetic resonance imaging was also obtained. Longer-term clinical outcomes were assessed using electronic health records. Compared to controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929), at 28\u201360\u2009days post-discharge, people with COVID-19 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009159; mean age, 55 years; 43% female) had persisting evidence of cardio-renal involvement and hemostasis pathway activation. The adjudicated likelihood of myocarditis was \u2018very likely\u2019 in 21 (13%) patients, \u2018probable\u2019 in 65 (41%) patients, \u2018unlikely\u2019 in 56 (35%) patients and \u2018not present\u2019 in 17 (11%) patients. At 28\u201360\u2009days post-discharge, COVID-19 was associated with worse health-related quality of life (EQ-5D-5L score 0.77 (0.23) versus 0.87 (0.20)), anxiety and depression (PHQ-4 total score 3.59 (3.71) versus 1.28 (2.67)) and aerobic exercise capacity reflected by predicted maximal oxygen utilization (20.0 (7.6) versus 29.5 (8.0) ml\/kg\/min) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). During follow-up (mean, 450\u2009days), 24 (15%) patients and two (7%) controls died or were rehospitalized, and 108 (68%) patients and seven (26%) controls received outpatient secondary care (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017). The illness trajectory of patients after hospitalization with COVID-19 includes persisting multisystem abnormalities and health impairments that could lead to substantial demand on healthcare services in the future.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41591-022-01837-9","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T11:05:05Z","timestamp":1653303905000},"page":"1303-1313","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["A multisystem, cardio-renal investigation of post-COVID-19 illness"],"prefix":"10.1038","volume":"28","author":[{"given":"Andrew 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