{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T23:57:00Z","timestamp":1783295820582,"version":"3.54.6"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>People with long Covid report a wide range of symptoms and inconsistent responses when seeking clinical diagnosis and support. Much of the qualitative research on long Covid has been based on people attending specialist clinical services or who have accessed support groups. We aimed to understand the varied experiences of persistent symptoms following Covid\u201019 and the impact on the lives of people affected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Qualitative interview study nested within the large, community\u2010based REal\u2010time Assessment of Community Transmission (REACT) study in England. Participants reporting persistent symptoms following Covid\u201019 were asked for consent to be contacted about a follow\u2010up interview. We then purposively sampled by age, gender, ethnicity and symptom severity and conducted 60 interviews. Analysis was carried out using a reflexive thematic analysis approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants were an ethnically diverse group aged between 18 and 80 years who reported symptoms following Covid\u201019 for between a few months and more than 2 years. Many had not accessed clinical care or specific long Covid support, and some did not identify with the category of long Covid, rendering their experiences largely invisible. Participants highlighted the ways in which they self\u2010manage symptoms within this context, and the varied burden of coping with ongoing health problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This diverse sample of people with long Covid report a range of challenges managing this emerging and contested condition, with uncertainty affecting their own understanding and the validation they receive from professionals, family and friends. These challenges intersect with others, such as racism, and are compounded by a lack of specific resources for long Covid as well as over\u2010stretched health services in the United Kingdom. Nevertheless, people report a variety of strategies in managing their symptoms, seeking information and support from a range of sources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Study design, analysis and drafting of paper informed by Patient Advisory Group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70428","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T16:04:54Z","timestamp":1757606694000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Challenges of Inclusion: A Population\u2010Based Interview Study of Long Covid"],"prefix":"10.1111","volume":"28","author":[{"given":"Emily","family":"Cooper","sequence":"first","affiliation":[{"name":"Patient Experience Research Centre School of Public Health, Imperial College London London UK"},{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Lound","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre School of Public Health, Imperial College London London UK"},{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Jones","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre School of Public Health, Imperial College London London UK"},{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Bruton","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre School of Public Health, Imperial College London London UK"},{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Day","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre School of Public Health, Imperial College London London UK"},{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina J.","family":"Atchison","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre School of Public Health, Imperial College London London UK"},{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Eccles","sequence":"additional","affiliation":[{"name":"Public Advisory Group member London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Piper","sequence":"additional","affiliation":[{"name":"Public Advisory Group member London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham S.","family":"Cooke","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"},{"name":"Department of Infectious Disease Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Chadeau\u2010Hyam","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"},{"name":"MRC Centre for Environment and Health, Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Elliott","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London UK"},{"name":"MRC Centre for Environment and Health, Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Ward","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre School of Public Health, Imperial College London London UK"},{"name":"National Institute for Health Research (NIHR) Imperial Biomedical Research Centre London 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J.Atchison et al. \u201cAwareness and Perceptions of Long COVID Among People in the REACT Programme: Early Insights From a Pilot Interview Study \u201dPLoS One18 no.1(January 2023):e0280943.","DOI":"10.1371\/journal.pone.0280943"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13687"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-41879-2"},{"key":"e_1_2_12_15_1","first-page":"377","volume-title":"Thematic Analysis: A Practical Guide","author":"Braun V.","year":"2021"},{"key":"e_1_2_12_16_1","unstructured":"\u201cHow Public Involvement Changed Our Research Question Exploring Experiences of People With Long Covid\u2014Patient Experience Research Centre \u201d published February 14 2024 https:\/\/blogs.imperial.ac.uk\/perc\/2024\/02\/13\/how-public-involvement-changed-our-research-question-exploring-experiences-of-people-with-long-covid\/."},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00703-9"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114619"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13518"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06295-6"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2005.06.018"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m693"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2022.05.019"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02809-7"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-18267-6"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00989485"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.13627"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.ep11339939"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-011-9354-4"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed-2024-001068"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-011-1931-2"},{"key":"e_1_2_12_32_1","unstructured":"SAGE Publications Inc. 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Thematic Analysis https:\/\/us.sagepub.com\/en-us\/nam\/thematic-analysis\/book248481."}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70428","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:12:50Z","timestamp":1766146370000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.70428"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,11]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/hex.70428"],"URL":"https:\/\/doi.org\/10.1111\/hex.70428","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,11]]},"assertion":[{"value":"2025-04-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70428"}}