{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:21:18Z","timestamp":1790824878957,"version":"4.1.0"},"reference-count":41,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006041","name":"Innovate\n                                    UK","doi-asserted-by":"publisher","award":["104688"],"award-info":[{"award-number":["104688"]}],"id":[{"id":"10.13039\/501100006041","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010675","name":"H2020\n                                    Innovation In SMEs","doi-asserted-by":"publisher","award":["719445"],"award-info":[{"award-number":["719445"]}],"id":[{"id":"10.13039\/100010675","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                        <jats:title>Objective<\/jats:title>\n                        <jats:p>To assess medium-term organ impairment in symptomatic individuals\n                            following recovery from acute SARS-CoV-2 infection.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Design<\/jats:title>\n                        <jats:p>Baseline findings from a prospective, observational cohort\n                            study.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Setting<\/jats:title>\n                        <jats:p>Community-based individuals from two UK centres between 1 April and\n                            14 September 2020.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Participants<\/jats:title>\n                        <jats:p>Individuals \u226518 years with persistent symptoms following recovery\n                            from acute SARS-CoV-2 infection and age-matched healthy\n                            controls.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Intervention<\/jats:title>\n                        <jats:p>Assessment of symptoms by standardised questionnaires (EQ-5D-5L,\n                            Dyspnoea-12) and organ-specific metrics by biochemical assessment and\n                            quantitative MRI.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Main outcome measures<\/jats:title>\n                        <jats:p>Severe post-COVID-19 syndrome defined as ongoing respiratory\n                            symptoms and\/or moderate functional impairment in activities of daily\n                            living; single-organ and multiorgan impairment (heart, lungs, kidneys,\n                            liver, pancreas, spleen) by consensus definitions at baseline\n                            investigation.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>201 individuals (mean age 45, range 21\u201371 years, 71% female, 88%\n                            white, 32% healthcare workers) completed the baseline assessment (median\n                            of 141 days following SARS-CoV-2 infection, IQR 110\u2013162). The study\n                            population was at low risk of COVID-19 mortality (obesity 20%,\n                            hypertension 7%, type 2 diabetes 2%, heart disease 5%), with only 19%\n                            hospitalised with COVID-19. 42% of individuals had 10 or more symptoms\n                            and 60% had severe post-COVID-19 syndrome. Fatigue (98%), muscle aches\n                            (87%), breathlessness (88%) and headaches (83%) were most frequently\n                            reported. Mild organ impairment was present in the heart (26%), lungs\n                            (11%), kidneys (4%), liver (28%), pancreas (40%) and spleen (4%), with\n                            single-organ and multiorgan impairment in 70% and 29%, respectively.\n                            Hospitalisation was associated with older age (p=0.001), non-white\n                            ethnicity (p=0.016), increased liver volume (p&lt;0.0001), pancreatic\n                            inflammation (p&lt;0.01), and fat accumulation in the liver (p&lt;0.05)\n                            and pancreas (p&lt;0.01). Severe post-COVID-19 syndrome was associated\n                            with radiological evidence of cardiac damage (myocarditis)\n                            (p&lt;0.05).<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>In individuals at low risk of COVID-19 mortality with ongoing\n                            symptoms, 70% have impairment in one or more organs 4\u2009months after\n                            initial COVID-19 symptoms, with implications for healthcare and public\n                            health, which have assumed low risk in young people with no\n                            comorbidities.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Trial registration number<\/jats:title>\n                        <jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04369807\">NCT04369807<\/jats:ext-link>; Pre-results.<\/jats:p>\n                    <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-048391","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T15:49:18Z","timestamp":1667576958000},"page":"e048391","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":428,"title":["Multiorgan impairment in low-risk individuals with post-COVID-19\n                        syndrome: a prospective, community-based study"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct04369807","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Andrea","family":"Dennis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata","family":"Wamil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Alberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jude","family":"Oben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J","family":"Cuthbertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wootton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Crooks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Gabbay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Brady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyth","family":"Hishmeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Attree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Heightman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajarshi","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8741-3411","authenticated-orcid":false,"given":"Amitava","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"key":"2022110304320531000_11.3.e048391.1","doi-asserted-by":"crossref","unstructured":"World Health Organization . 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