{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T13:22:52Z","timestamp":1793712172329,"version":"4.6.1"},"reference-count":60,"publisher":"BMJ","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2022,11,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the clinical sequelae of long covid for a year after infection in patients with mild disease and to evaluate its association with age, sex, SARS-CoV-2 variants, and vaccination status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective nationwide cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Electronic medical records from an Israeli nationwide healthcare organisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>1\u2009913\u2009234 Maccabi Healthcare Services members of all ages who did a polymerase chain reaction test for SARS-CoV-2 between 1 March 2020 and 1 October 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Risk of an evidence based list of 70 reported long covid outcomes in unvaccinated patients infected with SARS-CoV-2 matched to uninfected people, adjusted for age and sex and stratified by SARS-CoV-2 variants, and risk in patients with a breakthrough SARS-CoV-2 infection compared with unvaccinated infected controls. Risks were compared using hazard ratios and risk differences per 10\u2009000 patients measured during the early (30-180 days) and late (180-360 days) time periods after infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Covid-19 infection was significantly associated with increased risks in early and late periods for anosmia and dysgeusia (hazard ratio 4.59 (95% confidence interval 3.63 to 5.80), risk difference 19.6 (95% confidence interval 16.9 to 22.4) in early period; 2.96 (2.29 to 3.82), 11.0 (8.5 to 13.6) in late period), cognitive impairment (1.85 (1.58 to 2.17), 12.8, (9.6 to 16.1); 1.69 (1.45 to 1.96), 13.3 (9.4 to 17.3)), dyspnoea (1.79 (1.68 to 1.90), 85.7 (76.9 to 94.5); 1.30 (1.22 to 1.38), 35.4 (26.3 to 44.6)), weakness (1.78 (1.69 to 1.88), 108.5, 98.4 to 118.6; 1.30 (1.22 to 1.37), 50.2 (39.4 to 61.1)), and palpitations (1.49 (1.35 to 1.64), 22.1 (16.8 to 27.4); 1.16 (1.05 to 1.27), 8.3 (2.4 to 14.1)) and with significant but lower excess risk for streptococcal tonsillitis and dizziness. Hair loss, chest pain, cough, myalgia, and respiratory disorders were significantly increased only during the early phase. Male and female patients showed minor differences, and children had fewer outcomes than adults during the early phase of covid-19, which mostly resolved in the late period. Findings remained consistent across SARS-CoV-2 variants. Vaccinated patients with a breakthrough SARS-CoV-2 infection had a lower risk for dyspnoea and similar risk for other outcomes compared with unvaccinated infected patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This nationwide study suggests that patients with mild covid-19 are at risk for a small number of health outcomes, most of which are resolved within a year from diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2022-072529","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T20:20:17Z","timestamp":1673468417000},"page":"e072529","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":293,"title":["Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study"],"prefix":"10.1136","volume":"380","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1053-4773","authenticated-orcid":false,"given":"Barak","family":"Mizrahi","sequence":"first","affiliation":[{"name":"KI Research Institute, Kfar Malal, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Sudry","sequence":"additional","affiliation":[{"name":"KI Research Institute, Kfar Malal, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Flaks-Manov","sequence":"additional","affiliation":[{"name":"KI Research Institute, Kfar Malal, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Yehezkelli","sequence":"additional","affiliation":[{"name":"KI Research Institute, Kfar Malal, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Kalkstein","sequence":"additional","affiliation":[{"name":"KI Research Institute, Kfar Malal, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinchas","family":"Akiva","sequence":"additional","affiliation":[{"name":"KI Research Institute, Kfar Malal, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Ekka-Zohar","sequence":"additional","affiliation":[{"name":"Maccabi Healthcare Services, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley Shapiro","family":"Ben David","sequence":"additional","affiliation":[{"name":"Maccabi Healthcare Services, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uri","family":"Lerner","sequence":"additional","affiliation":[{"name":"Maccabi Healthcare Services, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maytal","family":"Bivas-Benita","sequence":"additional","affiliation":[{"name":"KI Research Institute, Kfar Malal, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shira","family":"Greenfeld","sequence":"additional","affiliation":[{"name":"Maccabi Healthcare Services, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"2025110102085924000_380.jan11_10.e072529.1","unstructured":"World Health Organization. Coronavirus Disease WHO Coronavirus (COVID-19) Dashboard. https:\/\/covid19.who.int\/."},{"key":"2025110102085924000_380.jan11_10.e072529.2","unstructured":"World Health Organization. Tracking SARS-CoV-2 variants. https:\/\/www.who.int\/activities\/tracking-SARS-CoV-2-variants."},{"key":"2025110102085924000_380.jan11_10.e072529.3","unstructured":"Centers for Disease Control and Prevention. COVID-19: Variants of the Virus. 2021. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/variants\/variant.html."},{"key":"2025110102085924000_380.jan11_10.e072529.4","unstructured":"World Health Organization. Coronavirus disease (COVID-19). https:\/\/www.who.int\/health-topics\/coronavirus."},{"key":"2025110102085924000_380.jan11_10.e072529.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-005427"},{"key":"2025110102085924000_380.jan11_10.e072529.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01755-4"},{"key":"2025110102085924000_380.jan11_10.e072529.7","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(21)00174-0"},{"key":"2025110102085924000_380.jan11_10.e072529.8","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01433-3"},{"key":"2025110102085924000_380.jan11_10.e072529.9","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00211-5"},{"key":"2025110102085924000_380.jan11_10.e072529.10","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9050575"},{"key":"2025110102085924000_380.jan11_10.e072529.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1098"},{"key":"2025110102085924000_380.jan11_10.e072529.12","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00084-5"},{"key":"2025110102085924000_380.jan11_10.e072529.13","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.11417"},{"key":"2025110102085924000_380.jan11_10.e072529.14","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01283-z"},{"key":"2025110102085924000_380.jan11_10.e072529.15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n693"},{"key":"2025110102085924000_380.jan11_10.e072529.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2022.04.013"},{"key":"2025110102085924000_380.jan11_10.e072529.17","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27456"},{"key":"2025110102085924000_380.jan11_10.e072529.18","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac136"},{"key":"2025110102085924000_380.jan11_10.e072529.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2022.100552"},{"key":"2025110102085924000_380.jan11_10.e072529.20","unstructured":"World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. https:\/\/www.who.int\/publications-detail-redirect\/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1."},{"key":"2025110102085924000_380.jan11_10.e072529.21","unstructured":"Centers for Disease Control and Prevention. Long COVID or Post-COVID Conditions. 2022. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/long-term-effects\/index.html."},{"key":"2025110102085924000_380.jan11_10.e072529.22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1648"},{"key":"2025110102085924000_380.jan11_10.e072529.23","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01292-y"},{"key":"2025110102085924000_380.jan11_10.e072529.24","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.0830"},{"key":"2025110102085924000_380.jan11_10.e072529.25","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-216086"},{"key":"2025110102085924000_380.jan11_10.e072529.26","unstructured":"Office for National Statistics. Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK. 2022. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/bulletins\/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk\/3march2022."},{"key":"2025110102085924000_380.jan11_10.e072529.27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034577"},{"key":"2025110102085924000_380.jan11_10.e072529.28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035389"},{"key":"2025110102085924000_380.jan11_10.e072529.29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00947-8"},{"key":"2025110102085924000_380.jan11_10.e072529.30","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2101765"},{"key":"2025110102085924000_380.jan11_10.e072529.31","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2114255"},{"key":"2025110102085924000_380.jan11_10.e072529.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00677-2"},{"key":"2025110102085924000_380.jan11_10.e072529.33","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1088"},{"key":"2025110102085924000_380.jan11_10.e072529.34","doi-asserted-by":"publisher","DOI":"10.7326\/M21-1976"},{"key":"2025110102085924000_380.jan11_10.e072529.35","unstructured":"UK Health Security Agency. The effectiveness of vaccination against long COVID A rapid evidence briefing. 2022. https:\/\/ukhsa.koha-ptfs.co.uk\/cgi-bin\/koha\/opac-retrieve-file.pl?id=fe4f10cd3cd509fe045ad4f72ae0dfff."},{"key":"2025110102085924000_380.jan11_10.e072529.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2022.06.003"},{"key":"2025110102085924000_380.jan11_10.e072529.37","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdab055"},{"key":"2025110102085924000_380.jan11_10.e072529.38","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2110475"},{"key":"2025110102085924000_380.jan11_10.e072529.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.cities.2021.103526"},{"key":"2025110102085924000_380.jan11_10.e072529.40","unstructured":"Central Bureau of Statistics of the State of Israel. Characterization and classification of geographical units by the socio-economic level of the population 2015. 2019. https:\/\/www.cbs.gov.il\/he\/publications\/DocLib\/2019\/1765_socio_economic_2015\/e_print.pd."},{"key":"2025110102085924000_380.jan11_10.e072529.41","unstructured":"Israeli Ministry of Health. The corona virus in Israel - a general picture. https:\/\/datadashboard.health.gov.il\/COVID-19\/general."},{"key":"2025110102085924000_380.jan11_10.e072529.42","unstructured":"Ministry of Health. The British Variant is the Most Common Cause of COVID-19 Cases in Israel. 2021. https:\/\/www.gov.il\/en\/departments\/news\/30032021-01."},{"key":"2025110102085924000_380.jan11_10.e072529.43","unstructured":"Israeli Ministry of Health. Discussion of the Management Team of Epidemics and the COVID-19 vaccines committee. 2021. https:\/\/www.gov.il\/BlobFolder\/reports\/vaccine-priorities-board\/he\/files_publications_corona_vaccine-priorities-board-20062021.pdf."},{"key":"2025110102085924000_380.jan11_10.e072529.44","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01840-0"},{"key":"2025110102085924000_380.jan11_10.e072529.45","unstructured":"Rajan S, Khunti K, Alwan N. In the wake of the pandemic: preparing for long COVID. 2021. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/339629\/Policy-brief-39-1997-8073-eng.pdf?sequence=1."},{"key":"2025110102085924000_380.jan11_10.e072529.46","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.033065"},{"key":"2025110102085924000_380.jan11_10.e072529.47","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2021.100122"},{"key":"2025110102085924000_380.jan11_10.e072529.48","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-216377"},{"key":"2025110102085924000_380.jan11_10.e072529.49","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(22)00004-9"},{"key":"2025110102085924000_380.jan11_10.e072529.50","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(21)00077-7"},{"key":"2025110102085924000_380.jan11_10.e072529.51","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0261332"},{"key":"2025110102085924000_380.jan11_10.e072529.52","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2006.01311.x"},{"key":"2025110102085924000_380.jan11_10.e072529.53","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v14.i5.1025"},{"key":"2025110102085924000_380.jan11_10.e072529.54","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-020-00459-7"},{"key":"2025110102085924000_380.jan11_10.e072529.55","unstructured":"Centers for Disease Control and Prevention. Risk for COVID-19 Infection, Hospitalization, and Death By Age Group. 2022. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/covid-data\/investigations-discovery\/hospitalization-death-by-age.html."},{"key":"2025110102085924000_380.jan11_10.e072529.56","doi-asserted-by":"publisher","DOI":"10.3390\/v14040827"},{"key":"2025110102085924000_380.jan11_10.e072529.57","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-07847-0"},{"key":"2025110102085924000_380.jan11_10.e072529.58","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-04690-5"},{"key":"2025110102085924000_380.jan11_10.e072529.59","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00941-2"},{"key":"2025110102085924000_380.jan11_10.e072529.60","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10050652"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj-2022-072529","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj-2022-072529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:09:10Z","timestamp":1761988150000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj-2022-072529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,11]]},"references-count":60,"alternative-id":["10.1136\/bmj-2022-072529"],"URL":"https:\/\/doi.org\/10.1136\/bmj-2022-072529","relation":{},"ISSN":["1756-1833"],"issn-type":[{"value":"1756-1833","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,11]]}}}