{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:15:02Z","timestamp":1785428102109,"version":"3.56.0"},"reference-count":70,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004281","name":"National Science Centre","doi-asserted-by":"publisher","award":["2020\/37\/B\/NZ7\/03380"],"award-info":[{"award-number":["2020\/37\/B\/NZ7\/03380"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2020\/37\/B\/NZ7\/03380"],"award-info":[{"award-number":["2020\/37\/B\/NZ7\/03380"]}],"id":[{"id":"https:\/\/ror.org\/03ha2q922","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Post-COVID-19 condition involves heterogeneous, multisystem symptoms with uncertain recovery. We characterized symptom trajectories from hospitalization to approximately 4 weeks and to 6\u20138 months and compared the 6\u20138-month symptom burden with season-matched controls, accounting for serology-identified, previously unrecognized infections. Methods: An individually pair-matched case\u2013control study of adults with RT-PCR\u2013confirmed SARS-CoV-2 and population controls from the Bialystok PLUS cohort, matched on age, sex and a two-month visit window, was performed. All participants underwent anti-nucleocapsid serology. Hospitalized cases were reassessed at approximately 4 weeks and 6\u20138 months. Cross-sectional outcomes used non-parametric tests and multivariable regression; longitudinal change used paired tests and generalized estimating equations. Results: We included 402 adults (201 post-COVID-19; 201 controls). In hospitalized cases, respiratory symptoms declined rapidly by approximately 4 weeks and remained low at 6\u20138 months; smell\/taste recovered more slowly; fatigue improved modestly; anxiety changed minimally. At 6\u20138 months, total symptom counts were higher in post-COVID-19 than in controls (median 4 vs. 2), with serology-positive controls intermediate (median 3). Excess burden was concentrated in non-respiratory domains (fatigue, neurocognitive, cardiovascular, and dermatologic), whereas respiratory differences were not significant. In the multivariable model, female sex remained an independent predictor of higher multisystem burden, whereas age, body mass index, hospitalization, and acute biomarker severity were not associated. Conclusions: Six to eight months after symptomatic COVID-19, multisystem symptom burden remains substantial relative to season-matched controls, despite substantial resolution of respiratory complaints. Serology-based identification of previously unrecognized infections indicates an intermediate burden and can guide targeted follow-up.<\/jats:p>","DOI":"10.3390\/jcm15103707","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:04:36Z","timestamp":1778601876000},"page":"3707","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptom Trajectories and Long-Term Sequelae of COVID-19: A Matched Case\u2013Control Study with Population-Based Controls"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1113-0997","authenticated-orcid":false,"given":"Sebastian","family":"So\u0142omacha","sequence":"first","affiliation":[{"name":"Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 15B, 15-269 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0290-4217","authenticated-orcid":false,"given":"Maciej","family":"Alimowski","sequence":"additional","affiliation":[{"name":"Society and Cognition Unit, University of Bialystok, Plac NZS 1, 15-403 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Moniuszko-Malinowska","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Neuroinfectious, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0712-3260","authenticated-orcid":false,"given":"\u0141ukasz","family":"Kiszkiel","sequence":"additional","affiliation":[{"name":"Society and Cognition Unit, University of Bialystok, Plac NZS 1, 15-403 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-607X","authenticated-orcid":false,"given":"Piotr","family":"Laskowski","sequence":"additional","affiliation":[{"name":"Society and Cognition Unit, University of Bialystok, Plac NZS 1, 15-403 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5977-0745","authenticated-orcid":false,"given":"Marlena","family":"Dubat\u00f3wka","sequence":"additional","affiliation":[{"name":"Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 15B, 15-269 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8357-5816","authenticated-orcid":false,"given":"Pawe\u0142","family":"Sowa","sequence":"additional","affiliation":[{"name":"Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 15B, 15-269 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9465-2581","authenticated-orcid":false,"given":"Karol","family":"Kami\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 15B, 15-269 Bialystok, Poland"},{"name":"Department of Cardiology and Internal Diseases, Medical University of Bialystok, ul. Sklodowskiej 24a, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-Acute COVID-19 Syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"The Lancet Editors (2023). Expression of Concern: 6-Month Consequences of COVID-19 in Patients Discharged from Hospital: A Cohort Study. Lancet, 401, 90.","DOI":"10.1016\/S0140-6736(22)02370-4"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"16144","DOI":"10.1038\/s41598-021-95565-8","article-title":"More than 50 Long-Term Effects of COVID-19: A Systematic Review and Meta-Analysis","volume":"11","author":"Perelman","year":"2021","journal-title":"Sci. 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