{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:33:16Z","timestamp":1787581996468,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long Covid (LC) is associated with long\u2010term health impacts that require ongoing support from healthcare services. We aimed to gain insights into patients' perceptions of their ongoing symptoms of LC, the effect on daily living and vocation, perceptions of what helps with LC recovery, as well as LC care pathways and ongoing care needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online survey was sent to 513 participants who had used one of three LC services across England and Wales between 2020 and 2024. Participants were invited to share their experiences. We employed a mixed\u2010methods approach for data analysis, synthesising findings from quantitative and qualitative data. All data shared between sites was de\u2010identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      269 (52.4%) participants completed the survey. The mean age was 52.7 (sd\u2009\u00b1\u200912.0), 69.1% female and 55.0% were White\u2010British. The mean duration since initial SARS\u2010CoV\u20102 infection was over 3 years (1204.4\u2009\u00b1\u2009275.7\u2009days). The Post\u2010Covid Functional Status (PCFS) scale indicated that most participants (94.1%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009253) had not fully recovered. When employing a global rate of change scale, 39.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200996) of 246 responders indicated they are still making improvements with respect to their recovery; 40.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009100) had plateaued, and 20.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950) reported a worsening trajectory. Those with ongoing symptoms described fatigue 83.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009210), cognitive dysfunction 58.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009148) and breathlessness or wheezing 43.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009111) most frequently. Of those who responded, 20.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948) were \u2018working as prior to their initial LC infection\u2019 and 25.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959) were currently \u2018unable to work\u2019. Almost half (44.3%;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200986) were no longer receiving care whilst also reporting unmet care needs. In total, 62.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009126) of participants indicated unmet care needs, and qualitative analysis indicated five overarching domains as having an important impact on long\u2010term LC recovery and ongoing healthcare needs. These were Living with LC, LC interventions and recovery, Approach to the delivery of care, Insufficient support and Suggestions and improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study indicates the extent to which individuals continue to experience ongoing symptoms of LC, including aspects related to recovery and vocational impact, highlighting the potential widening gap between the ongoing need to support those living with LC and the limited provision of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>The survey was co\u2010produced with Experts by Experience, who had previously attended an LC service and members of the Patient Advisory Group within the Locomotion Consortium. Collaboration and involvement continued throughout the study, including analysis, interpretation and writing processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      Study registration details are available at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      : NCT05057260 and ISRCTN: 15022307.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70435","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T07:19:33Z","timestamp":1762499973000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["What Can We Learn Four Years On? A Multi\u2010Centre Service Evaluation Exploring Symptoms, Functional Impact, Recovery and Care Pathways in Long Covid"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9449-0932","authenticated-orcid":false,"given":"Cassie","family":"Lee","sequence":"first","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1112-1825","authenticated-orcid":false,"given":"Paul","family":"Williams","sequence":"additional","affiliation":[{"name":"Hertfordshire Community NHS Trust Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5310-937X","authenticated-orcid":false,"given":"Amiad","family":"Abrahams","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"},{"name":"Central and Northwest London NHS London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7655-1963","authenticated-orcid":false,"given":"Julie","family":"Darbyshire","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences The University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-256X","authenticated-orcid":false,"given":"Helen E.","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Cardiff and Vale University Hospital Board, University Hospital Llandough, University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2468-5572","authenticated-orcid":false,"given":"Johannes","family":"De Kock","sequence":"additional","affiliation":[{"name":"NHS Highland Inverness UK"},{"name":"NWU School for Psychosocial Research  South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umut","family":"Esmer","sequence":"additional","affiliation":[{"name":"Person with Long Covid  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha A.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Cardiff and Vale University Hospital Board, University Hospital Llandough, University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Newey","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8030-5223","authenticated-orcid":false,"given":"Janet","family":"Scott","sequence":"additional","affiliation":[{"name":"Development and Innovation Department NHS Highland Inverness UK"},{"name":"MRC\u2010University of Glasgow Centre for Virus Research 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