{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:48:18Z","timestamp":1786632498058,"version":"build-2736575974"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000272","name":"DH | National Institute for Health Research","doi-asserted-by":"publisher","award":["COV-LT2-0043"],"award-info":[{"award-number":["COV-LT2-0043"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"DH | National Institute for Health Research","doi-asserted-by":"publisher","award":["COV-LT2-0043"],"award-info":[{"award-number":["COV-LT2-0043"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Med"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Combining multidisciplinary care plans into integrated care pathways (ICPs) is scalable, generalizable and effective for several long-term conditions, but not evaluated in Long COVID (LC). Our phase 3, cluster-randomized, multicenter clinical trial investigated the effectiveness of ICP interventions for LC. Recruitment of adults \u226518 years with LC was conducted in 6 National Health Service LC clinics in England with specialist ICPs. The intervention arms were (i) multi-organ magnetic resonance imaging (MRI; Coverscan), (ii) digital rehabilitation (Living with COVID Recovery), (iii) both multi-organ MRI and digital rehabilitation, and (iv) neither multi-organ MRI nor digital rehabilitation (usual care); cluster randomizing at primary care network (PCN) level to deliver interventions as \u2018standard of care\u2019 in that area. The primary endpoint was mean Fatigue Assessment Scale (FAS) at 12 weeks. Secondary endpoints included FAS at 24 weeks and EQ-5D-5L visual assessment scale at 12 and 24 weeks. A total of 1,152 participants from allocated PCNs consented to data collection, and 122 PCN clusters were allocated to the multi-organ MRI (33 PCNs), digital rehabilitation (32 PCNs), \u2018both\u2019 (27 PCNs) and \u2018neither\u2019 (30 PCNs) arms. Baseline FAS was equivalent across groups (mean 35.8, s.d. 8.21, 66.4% female). Overall, the primary outcome was achieved in all arms, with scores improving by 4.5 points to 31.3 (s.d. 9.31) at 12 weeks. Compared with usual care, effects on 12-week FAS were \u22120.18 (95% confidence interval \u22120.72, 1.09;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.69) with multi-organ MRI; \u22120.53 (\u22121.42, 0.36;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.25) with digital rehabilitation; and \u22120.17 (\u22121.06, 0.72;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.71) with their interaction. Absolute differences for other interventions from usual care were modest. There were no serious adverse events related to ICP interventions. Multidisciplinary holistic clinical care is associated with fatigue reduction in LC, irrespective of multi-organ MRI. Digital rehabilitation could be useful in longer-term LC management. Large, multi-site trials of optimal ICP interventions are feasible, but further trials are required. ISRCTN identifier:\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.isrctn.com\/ISRCTN10665760\" ext-link-type=\"uri\">ISRCTN10665760<\/jats:ext-link>\n                    .\n                  <\/jats:p>","DOI":"10.1038\/s41591-026-04552-x","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:02:15Z","timestamp":1785229335000},"page":"3040-3047","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated care pathway in individuals with Long COVID: STIMULATE-ICP, a cluster-randomized, phase 3 trial"],"prefix":"10.1038","volume":"32","author":[{"name":"STIMULATE-ICP Consortium","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Writing Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amitava","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Prescott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Wall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Leigh","family":"Watkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Heightman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Gibbon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al-Tahoor","family":"Butt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanpreet","family":"Sarna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Manzelat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Viswanathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Dennis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Clegg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Parabita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony","family":"Loveless","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashkan","family":"Dashtban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Latchford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Adams-Heath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Robson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M.","family":"van der Feltz-Cornelis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Hooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Cuthbertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wootton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William David","family":"Strain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sunkersing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Ravindran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Forshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Clutterbuck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eamonn","family":"Foley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bax","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Murray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Attree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Fraser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Mi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fauzia","family":"Begum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Mutesva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Gambino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"Allsopp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakim-Moulay","family":"Dehbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-I","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Grice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Goodfellow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh","family":"Montgomery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ileana L.","family":"Selejan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagdeep","family":"Sahota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai","family":"Prashar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Scott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Hayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Sweetman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Peel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Waywell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josie","family":"Newton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keri","family":"Hildick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Horstmanshof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumaran","family":"Balasundaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pasea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"O\u2019Mahoney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lere","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyth","family":"Hishmeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mag","family":"Leahy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Gomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Pantelic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Gabbay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew Robert","family":"Burns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Leach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mel","family":"Ramasawmy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Crooks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Zandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nataliia","family":"Kryvutenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nefyn","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisreen A.","family":"Alwan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ondine","family":"Sherwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Fernandez","family":"Medina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Lorgelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Cumberlidge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael A.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Botell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Hext","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Nyam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajarshi","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Livingston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Mallinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Suriano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Eccles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Clegg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Burchell-Kirk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Equi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Cone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence","family":"Elliott-Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby","family":"Hillman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tushy","family":"Kailayanathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Benedetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"4552_CR1","doi-asserted-by":"publisher","first-page":"113728","DOI":"10.1016\/j.socscimed.2021.113728","volume":"277","author":"W Looman","year":"2021","unstructured":"Looman, W. et al. Drivers of successful implementation of integrated care for multi-morbidity: mechanisms identified in 17 case studies from 8 European countries. Soc. Sci. Med. 277, 113728 (2021).","journal-title":"Soc. Sci. Med."},{"key":"4552_CR2","doi-asserted-by":"publisher","unstructured":"Integrating Care to Prevent and Manage Chronic Diseases (OECD, 2023); https:\/\/doi.org\/10.1787\/9acc1b1d-en","DOI":"10.1787\/9acc1b1d-en"},{"key":"4552_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3161-3","volume":"18","author":"S Baxter","year":"2018","unstructured":"Baxter, S. et al. The effects of integrated care: a systematic review of UK and international evidence. BMC Health Serv. Res. 18, 350 (2018).","journal-title":"BMC Health Serv. Res."},{"key":"4552_CR4","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","volume":"396","author":"T Vos","year":"2020","unstructured":"Vos, T. et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396, 1204\u20131222 (2020).","journal-title":"Lancet"},{"key":"4552_CR5","unstructured":"Five Year Forward View (NHS England, 2014); https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2014\/10\/5yfv-web.pdf"},{"key":"4552_CR6","doi-asserted-by":"publisher","first-page":"422","DOI":"10.3399\/bjgp23X734925","volume":"73","author":"C van der Feltz-Cornelis","year":"2023","unstructured":"van der Feltz-Cornelis, C., Attree, E., Heightman, M., Gabbay, M. & Allsopp, G. Integrated care pathways: a new approach for integrated care systems. Br. J. Gen. Pract. 73, 422\u2013422 (2023).","journal-title":"Br. J. Gen. Pract."},{"key":"4552_CR7","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-64060-1","volume":"14","author":"CM van der Feltz-Cornelis","year":"2024","unstructured":"van der Feltz-Cornelis, C. M. et al. Integrated care policy recommendations for complex multisystem long term conditions and long COVID. Sci. Rep. 14, 13634 (2024).","journal-title":"Sci. Rep."},{"key":"4552_CR8","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1038\/s41590-024-01778-0","volume":"25","author":"F Liew","year":"2024","unstructured":"Liew, F. et al. Large-scale phenotyping of patients with long COVID post-hospitalization reveals mechanistic subtypes of disease. Nat. Immunol. 25, 607\u2013621 (2024).","journal-title":"Nat. Immunol."},{"key":"4552_CR9","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1016\/S1473-3099(23)00287-6","volume":"23","author":"Z Al-Aly","year":"2023","unstructured":"Al-Aly, Z. Prevention of long COVID: progress and challenges. Lancet Infect. Dis. 23, 776\u2013777 (2023).","journal-title":"Lancet Infect. Dis."},{"key":"4552_CR10","doi-asserted-by":"publisher","first-page":"2148","DOI":"10.1038\/s41591-024-03173-6","volume":"30","author":"Z Al-Aly","year":"2024","unstructured":"Al-Aly, Z. et al. Long COVID science, research and policy. Nat. Med. 30, 2148\u20132164 (2024).","journal-title":"Nat. Med."},{"key":"4552_CR11","doi-asserted-by":"publisher","first-page":"e001041","DOI":"10.1136\/bmjresp-2021-001041","volume":"8","author":"M Heightman","year":"2021","unstructured":"Heightman, M. et al. Post-COVID-19 assessment in a specialist clinical service: a 12-month, single-centre, prospective study in 1325 individuals. BMJ Open Respir. Res. 8, e001041 (2021).","journal-title":"BMJ Open Respir. Res."},{"key":"4552_CR12","doi-asserted-by":"publisher","first-page":"n693","DOI":"10.1136\/bmj.n693","volume":"372","author":"D Ayoubkhani","year":"2021","unstructured":"Ayoubkhani, D. et al. Post-COVID syndrome in individuals admitted to hospital with COVID-19: retrospective cohort study. BMJ 372, n693 (2021).","journal-title":"BMJ"},{"key":"4552_CR13","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1177\/01410768231154703","volume":"116","author":"A Dennis","year":"2023","unstructured":"Dennis, A. et al. Multi-organ impairment and long COVID: a 1-year prospective, longitudinal cohort study. J. R. Soc. Med. 116, 97\u2013112 (2023).","journal-title":"J. R. Soc. Med."},{"key":"4552_CR14","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.1038\/s41591-023-02521-2","volume":"29","author":"B Bowe","year":"2023","unstructured":"Bowe, B., Xie, Y. & Al-Aly, Z. Postacute sequelae of COVID-19 at 2 years. Nat. Med. 29, 2347\u20132357 (2023).","journal-title":"Nat. Med."},{"key":"4552_CR15","doi-asserted-by":"publisher","first-page":"e0272472","DOI":"10.1371\/journal.pone.0272472","volume":"18","author":"D Forshaw","year":"2023","unstructured":"Forshaw, D. et al. STIMULATE-ICP: a pragmatic, multi-centre, cluster randomised trial of an integrated care pathway with a nested, phase III, open label, adaptive platform randomised drug trial in individuals with Long COVID: a structured protocol. PLoS ONE 18, e0272472 (2023).","journal-title":"PLoS ONE"},{"key":"4552_CR16","doi-asserted-by":"publisher","first-page":"e057408","DOI":"10.1136\/bmjopen-2021-057408","volume":"12","author":"E Murray","year":"2022","unstructured":"Murray, E. et al. Development, deployment and evaluation of digitally enabled, remote, supported rehabilitation for people with Long COVID-19 (Living With COVID-19 Recovery): protocol for a mixed-methods study. BMJ Open 12, e057408 (2022).","journal-title":"BMJ Open"},{"key":"4552_CR17","doi-asserted-by":"publisher","first-page":"e14008","DOI":"10.1111\/hex.14008","volume":"27","author":"F Turk","year":"2024","unstructured":"Turk, F. et al. Accessing care for Long COVID from the perspectives of patients and healthcare practitioners: a qualitative study. Health Expect. 27, e14008 (2024).","journal-title":"Health Expect."},{"key":"4552_CR18","doi-asserted-by":"publisher","first-page":"e815","DOI":"10.3399\/BJGP.2021.0265","volume":"71","author":"M Nurek","year":"2021","unstructured":"Nurek, M. et al. Recommendations for the recognition, diagnosis, and management of Long COVID: a Delphi study. Br. J. Gen. Pract. 71, e815\u2013e825 (2021).","journal-title":"Br. J. Gen. Pract."},{"key":"4552_CR19","doi-asserted-by":"publisher","first-page":"1641411","DOI":"10.3389\/fmed.2025.1641411","volume":"12","author":"L Gu","year":"2025","unstructured":"Gu, L., Yue, J., Lin, J., Liu, Z. & Huang, J. Challenges in diagnosis and treatment of Long COVID. Front. Med. 12, 1641411 (2025).","journal-title":"Front. Med."},{"key":"4552_CR20","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s12941-025-00793-9","volume":"24","author":"AG Ewing","year":"2025","unstructured":"Ewing, A. G. et al. Long COVID clinical evaluation, research and impact on society: a global expert consensus. Ann. Clin. Microbiol. Antimicrob. 24, 27 (2025).","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"4552_CR21","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","volume":"21","author":"HE Davis","year":"2023","unstructured":"Davis, H. E., McCorkell, L., Vogel, J. M. & Topol, E. J. Long COVID: major findings, mechanisms and recommendations. Nat. Rev. Microbiol. 21, 133\u2013146 (2023).","journal-title":"Nat. Rev. Microbiol."},{"key":"4552_CR22","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1109\/MPULS.2021.3078603","volume":"12","author":"W Yan","year":"2021","unstructured":"Yan, W. Can Coverscan help COVID-19 survivors? IEEE Pulse 12, 18\u201320 (2021).","journal-title":"IEEE Pulse"},{"key":"4552_CR23","doi-asserted-by":"publisher","first-page":"e069217","DOI":"10.1136\/bmjopen-2022-069217","volume":"13","author":"S Walker","year":"2023","unstructured":"Walker, S. et al. Impact of fatigue as the primary determinant of functional limitations among patients with post-COVID-19 syndrome: a cross-sectional observational study. BMJ Open 13, e069217 (2023).","journal-title":"BMJ Open"},{"key":"4552_CR24","doi-asserted-by":"publisher","first-page":"e088538","DOI":"10.1136\/bmjopen-2024-088538","volume":"14","author":"J Wang","year":"2024","unstructured":"Wang, J. et al. Trajectories of functional limitations, health-related quality of life and societal costs in individuals with Long COVID: a population-based longitudinal cohort study. BMJ Open 14, e088538 (2024).","journal-title":"BMJ Open"},{"key":"4552_CR25","doi-asserted-by":"publisher","first-page":"205427042412742","DOI":"10.1177\/20542704241274292","volume":"15","author":"D Sunkersing","year":"2024","unstructured":"Sunkersing, D. et al. Long COVID symptoms and demographic associations: a retrospective case series study using healthcare application data. JRSM Open 15, 20542704241274292 (2024).","journal-title":"JRSM Open"},{"key":"4552_CR26","doi-asserted-by":"publisher","first-page":"e092824","DOI":"10.1136\/bmjopen-2024-092824","volume":"14","author":"FA Stevenson","year":"2024","unstructured":"Stevenson, F. A. et al. Using normalisation process theory to evaluate the implementation of a digital health intervention in community and secondary care long COVID clinics. BMJ Open 14, e092824 (2024).","journal-title":"BMJ Open"},{"key":"4552_CR27","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1007\/s11136-013-0537-z","volume":"23","author":"Y Feng","year":"2014","unstructured":"Feng, Y., Parkin, D. & Devlin, N. J. Assessing the performance of the EQ-VAS in the NHS PROMs programme. Qual. Life Res. 23, 977\u2013989 (2014).","journal-title":"Qual. Life Res."},{"key":"4552_CR28","doi-asserted-by":"publisher","unstructured":"STIMULATE-ICP Consortium. Efficacy and safety of rivaroxaban, colchicine, and famotidine-loratadine with specialist supportive clinical care for fatigue in patients with post-COVID-19 condition in the UK: a multisite, open-label, randomised controlled trial. Lancet Infect. Dis. https:\/\/doi.org\/10.1016\/S1473-3099(26)00242-2 (2026).","DOI":"10.1016\/S1473-3099(26)00242-2"},{"key":"4552_CR29","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1016\/j.rmed.2011.05.004","volume":"105","author":"WPE de Kleijn","year":"2011","unstructured":"de Kleijn, W. P. E., De Vries, J., Wijnen, P. A. H. M. & Drent, M. Minimal (clinically) important differences for the Fatigue Assessment Scale in sarcoidosis. Respir. Med. 105, 1388\u20131395 (2011).","journal-title":"Respir. Med."},{"key":"4552_CR30","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1038\/s41591-023-02296-6","volume":"29","author":"YE Tian","year":"2023","unstructured":"Tian, Y. E. et al. Heterogeneous aging across multiple organ systems and prediction of chronic disease and mortality. Nat. Med. 29, 1221\u20131231 (2023).","journal-title":"Nat. Med."},{"key":"4552_CR31","doi-asserted-by":"publisher","first-page":"1129459","DOI":"10.3389\/fimmu.2023.1129459","volume":"14","author":"H Bonilla","year":"2023","unstructured":"Bonilla, H. et al. Therapeutic trials for Long COVID-19: a call to action from the interventions taskforce of the RECOVER initiative. Front. Immunol. 14, 1129459 (2023).","journal-title":"Front. Immunol."},{"key":"4552_CR32","doi-asserted-by":"publisher","first-page":"9566","DOI":"10.3390\/ijerph19159566","volume":"19","author":"M-J Estebanez-P\u00e9rez","year":"2022","unstructured":"Estebanez-P\u00e9rez, M.-J., Pastora-Bernal, J.-M. & Mart\u00edn-Valero, R. The effectiveness of a four-week digital physiotherapy intervention to improve functional capacity and adherence to intervention in patients with Long COVID-19. Int. J. Environ. Res. Public Health 19, 9566 (2022).","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"4552_CR33","doi-asserted-by":"publisher","first-page":"e49342","DOI":"10.2196\/49342","volume":"25","author":"C Derksen","year":"2023","unstructured":"Derksen, C. et al. Longitudinal evaluation of an integrated Post\u2013COVID-19\/Long COVID management program consisting of digital interventions and personal support: randomized controlled trial. J. Med. Internet Res. 25, e49342 (2023).","journal-title":"J. Med. Internet Res."},{"key":"4552_CR34","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-024-01354-w","volume":"82","author":"S Le\u00f3n-Herrera","year":"2024","unstructured":"Le\u00f3n-Herrera, S. et al. Effectiveness of an online multimodal rehabilitation program in Long COVID patients: a randomized clinical trial. Arch. Public Health 82, 159 (2024).","journal-title":"Arch. Public Health"},{"key":"4552_CR35","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1038\/s41386-024-01995-z","volume":"50","author":"LW Victoria","year":"2025","unstructured":"Victoria, L. W. et al. A digital intervention for cognitive deficits following COVID-19: a randomized clinical trial. Neuropsychopharmacology 50, 472\u2013479 (2025).","journal-title":"Neuropsychopharmacology"},{"key":"4552_CR36","doi-asserted-by":"publisher","unstructured":"Zeraatkar, D. et al. Interventions for the management of Long COVID (post-COVID condition): living systematic review. BMJ https:\/\/doi.org\/10.1136\/bmj-2024-081318 (2024).","DOI":"10.1136\/bmj-2024-081318"},{"key":"4552_CR37","doi-asserted-by":"publisher","first-page":"868","DOI":"10.23736\/S1973-9087.24.08540-X","volume":"60","author":"O Mart\u00ednez-Pozas","year":"2024","unstructured":"Mart\u00ednez-Pozas, O. et al. Effectiveness of telerehabilitation versus face-to-face pulmonary rehabilitation on physical function and quality of life in people with post COVID-19 condition: a systematic review and network meta-analysis. Eur. J. Phys. Rehabil. Med. 60, 868\u2013877 (2024).","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"4552_CR38","doi-asserted-by":"publisher","first-page":"100237","DOI":"10.1016\/j.clinme.2024.100237","volume":"24","author":"J Darbyshire","year":"2024","unstructured":"Darbyshire, J. et al. Improving quality in adult Long COVID services: findings from the LOCOMOTION quality improvement collaborative. Clin. Med. 24, 100237 (2024).","journal-title":"Clin. Med."},{"key":"4552_CR39","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-024-01260-1","volume":"23","author":"Y Zhang","year":"2025","unstructured":"Zhang, Y., Stokes, J., Anselmi, L., Bower, P. & Xu, J. Can integrated care interventions strengthen primary care and improve outcomes for patients with chronic diseases? A systematic review and meta-analysis. Health Res. Policy Syst. 23, 5 (2025).","journal-title":"Health Res. Policy Syst."},{"key":"4552_CR40","doi-asserted-by":"publisher","first-page":"e567","DOI":"10.1016\/S2589-7500(22)00122-4","volume":"4","author":"ML Murray","year":"2022","unstructured":"Murray, M. L. et al. Data provenance and integrity of health-care systems data for clinical trials. Lancet Digit Health 4, e567\u2013e568 (2022).","journal-title":"Lancet Digit Health"},{"key":"4552_CR41","first-page":"80","volume":"7","author":"D Allen","year":"2009","unstructured":"Allen, D., Gillen, E. & Rixson, L. The effectiveness of integrated care pathways for adults and children in health care settings: a systematic review. JBI Libr. Syst. Rev. 7, 80\u2013129 (2009).","journal-title":"JBI Libr. Syst. Rev."},{"key":"4552_CR42","doi-asserted-by":"publisher","first-page":"e048391","DOI":"10.1136\/bmjopen-2020-048391","volume":"11","author":"A Dennis","year":"2021","unstructured":"Dennis, A. et al. Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: a prospective, community-based study. BMJ Open 11, e048391 (2021).","journal-title":"BMJ Open"},{"key":"4552_CR43","doi-asserted-by":"publisher","first-page":"e002241","DOI":"10.1136\/openhrt-2022-002241","volume":"10","author":"A Roca-Fernandez","year":"2023","unstructured":"Roca-Fernandez, A. et al. Cardiac abnormalities in Long COVID 1-year post-SARS-CoV-2 infection. Open Heart. 10, e002241 (2023).","journal-title":"Open Heart."},{"key":"4552_CR44","unstructured":"Commissioning guidance for post-COVID services for adults, children and young people. NHS England https:\/\/www.england.nhs.uk\/long-read\/commissioning-guidance-for-post-covid-services-for-adults-children-and-young-people\/ (2023)."},{"key":"4552_CR45","doi-asserted-by":"publisher","first-page":"e103884","DOI":"10.1136\/bmjopen-2025-103884","volume":"16","author":"J Prashar","year":"2026","unstructured":"Prashar, J. et al. Trajectory, healthcare utilisation and recovery in 3590 individuals with Long COVID: a 4-year prospective cohort analysis. BMJ Open 16, e103884 (2026).","journal-title":"BMJ Open"},{"key":"4552_CR46","doi-asserted-by":"publisher","first-page":"e080967","DOI":"10.1136\/bmjopen-2023-080967","volume":"14","author":"D Sunkersing","year":"2024","unstructured":"Sunkersing, D. et al. What is current care for people with Long COVID in England? A qualitative interview study. BMJ Open 14, e080967 (2024).","journal-title":"BMJ Open"},{"key":"4552_CR47","doi-asserted-by":"publisher","first-page":"5474","DOI":"10.1002\/sim.9135","volume":"40","author":"AJ Copas","year":"2021","unstructured":"Copas, A. J. & Hooper, R. Optimal design of cluster randomized trials allowing unequal allocation of clusters and unequal cluster size between arms. Stat Med. 40, 5474\u20135486 (2021).","journal-title":"Stat Med."},{"key":"4552_CR48","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1056\/NEJMoa2021436","volume":"384","author":"RECOVERY Collaborative Group","year":"2021","unstructured":"RECOVERY Collaborative Group et al. Dexamethasone in hospitalized patients with COVID-19. N. Engl. J. Med. 384, 693\u2013704 (2021).","journal-title":"N. Engl. J. Med."},{"key":"4552_CR49","doi-asserted-by":"publisher","first-page":"101019","DOI":"10.1016\/j.eclinm.2021.101019","volume":"38","author":"HE Davis","year":"2021","unstructured":"Davis, H. E. et al. Characterizing Long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 38, 101019 (2021).","journal-title":"EClinicalMedicine"},{"key":"4552_CR50","doi-asserted-by":"publisher","first-page":"e074425","DOI":"10.1136\/bmj-2022-074425","volume":"381","author":"T Ballouz","year":"2023","unstructured":"Ballouz, T. et al. Recovery and symptom trajectories up to two years after SARS-CoV-2 infection: population based, longitudinal cohort study. BMJ 381, e074425 (2023).","journal-title":"BMJ"},{"key":"4552_CR51","doi-asserted-by":"publisher","first-page":"e081123","DOI":"10.1136\/bmj-2024-081123","volume":"389","author":"S Hopewell","year":"2025","unstructured":"Hopewell, S. et al. CONSORT 2025 statement: updated guideline for reporting randomised trials. BMJ 389, e081123 (2025).","journal-title":"BMJ"},{"key":"4552_CR52","doi-asserted-by":"publisher","first-page":"e5661","DOI":"10.1136\/bmj.e5661","volume":"345","author":"MK Campbell","year":"2012","unstructured":"Campbell, M. K. et al. Consort 2010 statement: extension to cluster randomised trials. BMJ 345, e5661 (2012).","journal-title":"BMJ"}],"container-title":["Nature Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04552-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04552-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04552-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:01:44Z","timestamp":1786629704000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04552-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":52,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["4552"],"URL":"https:\/\/doi.org\/10.1038\/s41591-026-04552-x","relation":{},"ISSN":["1078-8956","1546-170X"],"issn-type":[{"value":"1078-8956","type":"print"},{"value":"1546-170X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"15 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2026","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"In the version of the article initially published, most members of the STIMULATE-ICP Consortium were listed with the wrong affiliation. This has now been corrected in the HTML and PDF versions of the article.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A.C., T.K., A.D. and K. Hildick are employees of and have shares in Perspectum Ltd. R.B. was the founder and CEO of Perspectum Ltd until 2025. C.R. and J.W. are employees of Living With; C.R. is the founder. The other authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}