{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T19:53:08Z","timestamp":1768679588524,"version":"3.49.0"},"reference-count":67,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health~Holland","award":["LSHM20104"],"award-info":[{"award-number":["LSHM20104"]}]},{"name":"Health~Holland","award":["LSHM20068"],"award-info":[{"award-number":["LSHM20068"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Introduction: The coronavirus disease 2019 (COVID-19) pandemic has led to the death of almost 7 million people, however, with a cumulative incidence of 0.76 billion, most people survive COVID-19. Several studies indicate that the acute phase of COVID-19 may be followed by persistent symptoms including fatigue, dyspnea, headache, musculoskeletal symptoms, and pulmonary functional-and radiological abnormalities. However, the impact of COVID-19 on long-term health outcomes remains to be elucidated. Aims: The Precision Medicine for more Oxygen (P4O2) consortium COVID-19 extension aims to identify long COVID patients that are at risk for developing chronic lung disease and furthermore, to identify treatable traits and innovative personalized therapeutic strategies for prevention and treatment. This study aims to describe the study design and first results of the P4O2 COVID-19 cohort. Methods: The P4O2 COVID-19 study is a prospective multicenter cohort study that includes nested personalized counseling intervention trial. Patients, aged 40\u201365 years, were recruited from outpatient post-COVID clinics from five hospitals in The Netherlands. During study visits at 3\u20136 and 12\u201318 months post-COVID-19, data from medical records, pulmonary function tests, chest computed tomography scans and biological samples were collected and questionnaires were administered. Furthermore, exposome data was collected at the patient\u2019s home and state-of-the-art imaging techniques as well as multi-omics analyses will be performed on collected data. Results: 95 long COVID patients were enrolled between May 2021 and September 2022. The current study showed persistence of clinical symptoms and signs of pulmonary function test\/radiological abnormalities in post-COVID patients at 3\u20136 months post-COVID. The most commonly reported symptoms included respiratory symptoms (78.9%), neurological symptoms (68.4%) and fatigue (67.4%). Female sex and infection with the Delta, compared with the Beta, SARS-CoV-2 variant were significantly associated with more persisting symptom categories. Conclusions: The P4O2 COVID-19 study contributes to our understanding of the long-term health impacts of COVID-19. Furthermore, P4O2 COVID-19 can lead to the identification of different phenotypes of long COVID patients, for example those that are at risk for developing chronic lung disease. Understanding the mechanisms behind the different phenotypes and identifying these patients at an early stage can help to develop and optimize prevention and treatment strategies.<\/jats:p>","DOI":"10.3390\/jpm13071060","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:41:45Z","timestamp":1687999305000},"page":"1060","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Precision Medicine for More Oxygen (P4O2)\u2014Study Design and First Results of the Long COVID-19 Extension"],"prefix":"10.3390","volume":"13","author":[{"given":"Nadia","family":"Baalbaki","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2047-0888","authenticated-orcid":false,"given":"Jelle M.","family":"Blankestijn","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9263-7137","authenticated-orcid":false,"given":"Mahmoud I.","family":"Abdel-Aziz","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"},{"name":"Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"de Backer","sequence":"additional","affiliation":[{"name":"Fluidda, Groeningenlei 132, 2550 Kontich, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8266-8156","authenticated-orcid":false,"given":"Somayeh","family":"Bazdar","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00e9s","family":"Beekers","sequence":"additional","affiliation":[{"name":"ORTEC BV, Department of Health, Houtsingel 5, 2719 EA Zoetermeer, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosanne J. H. C. G.","family":"Beijers","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joop P.","family":"van den Bergh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Internal Medicine, VieCuri Medical Center, 5912 BL Venlo, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lizan D.","family":"Bloemsma","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5371-0346","authenticated-orcid":false,"given":"Harm Jan","family":"Bogaard","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7133-955X","authenticated-orcid":false,"given":"Job J. M. H.","family":"van Bragt","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera","family":"van den Brink","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Paul","family":"Charbonnier","sequence":"additional","affiliation":[{"name":"Thirona, Toernooiveld 300, 6525 EC Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merel E. B.","family":"Cornelissen","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yennece","family":"Dagelet","sequence":"additional","affiliation":[{"name":"Breathomix B.V., Bargelaan 200, 2333 CW Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elin Haf","family":"Davies","sequence":"additional","affiliation":[{"name":"Aparito Netherlands B.V., Galileiweg 8, BioPartner 3 Building, 2333 BD Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne M.","family":"van der Does","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George S.","family":"Downward","sequence":"additional","affiliation":[{"name":"Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CL Utrecht, The Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelis M.","family":"van Drunen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie","family":"Gach","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. J. Miranda","family":"Geelhoed","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorrit","family":"Glastra","sequence":"additional","affiliation":[{"name":"Quantib-U, Westblaak 106, 3012 KM Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kornel","family":"Golebski","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Department of Otorhinolaryngology, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1260-8932","authenticated-orcid":false,"given":"Irene H.","family":"Heijink","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands"},{"name":"Department Pathology & Medical Biology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith C. S.","family":"Holtjer","sequence":"additional","affiliation":[{"name":"Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CL Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastiaan","family":"Holverda","sequence":"additional","affiliation":[{"name":"Longfonds, Stationsplein 125, 3818 LE Amersfoort, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Houweling","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CL Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2249-5668","authenticated-orcid":false,"given":"John J. L.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"ORTEC BV, Department of Health, Houtsingel 5, 2719 EA Zoetermeer, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9e","family":"Jonker","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9895-9636","authenticated-orcid":false,"given":"Renate","family":"Kos","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramon C. J.","family":"Langen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivo","family":"van der Lee","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Spaarne Hospital, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asabi","family":"Leliveld","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firdaus A. A.","family":"Mohamed Hoesein","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Center Utrecht and Utrecht University, 3508 GA Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne H.","family":"Neerincx","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4528-6351","authenticated-orcid":false,"given":"Lieke","family":"Noij","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Olsson","sequence":"additional","affiliation":[{"name":"Smartfish AS, Oslo Science Park, Gaustadall\u00e9en 21, 0349 Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"van de Pol","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-8061","authenticated-orcid":false,"given":"Simon D.","family":"Pouwels","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands"},{"name":"Department Pathology & Medical Biology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emiel","family":"Rolink","sequence":"additional","affiliation":[{"name":"Long Alliantie Nederland, Address Stationsplein 125, 3818 LE Amersfoort, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Rutgers","sequence":"additional","affiliation":[{"name":"Longfonds, Stationsplein 125, 3818 LE Amersfoort, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Havva","family":"\u0218ahin","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daphne","family":"Schaminee","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemie M. W. J.","family":"Schols","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisanne","family":"Schuurman","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gitte","family":"Slingers","sequence":"additional","affiliation":[{"name":"Breathomix B.V., Bargelaan 200, 2333 CW Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olie","family":"Smeenk","sequence":"additional","affiliation":[{"name":"Sodaq, Bussumerstraat 34, 1211 BL Hilversum, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Sondermeijer","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Spaarne Hospital, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Skipp","sequence":"additional","affiliation":[{"name":"TopMD Precision Medicine Ltdincorporated, Southhampton SO45 3PN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisca","family":"Tamarit","sequence":"additional","affiliation":[{"name":"Breathomix B.V., Bargelaan 200, 2333 CW Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inge","family":"Verkouter","sequence":"additional","affiliation":[{"name":"ORTEC BV, Department of Health, Houtsingel 5, 2719 EA Zoetermeer, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roel","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CL Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rianne","family":"de Vries","sequence":"additional","affiliation":[{"name":"Breathomix B.V., Bargelaan 200, 2333 CW Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Els J. M.","family":"Weersink","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4230-1863","authenticated-orcid":false,"given":"Marco","family":"van de Werken","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"de Wit-van Wijck","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stewart","family":"Young","sequence":"additional","affiliation":[{"name":"Philips GmbH Innovative Technologies, 4646 AG Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther J.","family":"Nossent","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0414-3442","authenticated-orcid":false,"given":"Anke H.","family":"Maitland-van der Zee","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,28]]},"reference":[{"key":"ref_1","first-page":"e0241875","article-title":"Symptoms and symptom clusters associated with SARS-CoV-2 infection in community-based populations: Results from a statewide epidemiological study","volume":"16","author":"Dixon","year":"2020","journal-title":"Public Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1164\/rccm.202006-2157CP","article-title":"Why COVID-19 Silent Hypoxemia Is Baffling to Physicians","volume":"202","author":"Tobin","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11727","DOI":"10.1073\/pnas.2003138117","article-title":"Cell Entry Mechanisms of SARS-CoV-2","volume":"117","author":"Shang","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/path.1570","article-title":"Tissue Distribution of ACE2 Protein, the Functional Receptor for SARS Coronavirus. A First Step in Understanding SARS Pathogenesis","volume":"203","author":"Hamming","year":"2004","journal-title":"J. Pathol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S0140-6736(20)32656-8","article-title":"6-Month Consequences of COVID-19 in Patients Discharged from Hospital: A Cohort Study","volume":"397","author":"Huang","year":"2021","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1001\/jama.2020.12603","article-title":"Persistent Symptoms in Patients After Acute COVID-19","volume":"324","author":"Bernabei","year":"2020","journal-title":"JAMA"},{"key":"ref_8","unstructured":"World Health Organization (2021). A Clinical Case Definition of Post COVID-19 Condition by a Delphi Consensus, World Health Organization."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Taquet, M., Dercon, Q., Luciano, S., Geddes, J.R., Husain, M., and Harrison, P.J. (2021). Incidence, Co-Occurrence, and Evolution of Long-COVID Features: A 6-Month Retrospective Cohort Study of 273,618 Survivors of COVID-19. PLoS Med., 18.","DOI":"10.1371\/journal.pmed.1003773"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e2128568","DOI":"10.1001\/jamanetworkopen.2021.28568","article-title":"Short-Term and Long-Term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review","volume":"4","author":"Groff","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref_11","unstructured":"World Health Organization (2022, June 06). At Least 17 Million People in the WHO European Region Experienced Long COVID in the First Two Years of the Pandemic; Millions May Have to Live with It for Years to Come. Available online: https:\/\/www.who.int\/europe\/news\/item\/13-09-2022-at-least-17-million-people-in-the-who-european-region-experienced-long-covid-in-the-first-two-years-of-the-pandemic--millions-may-have-to-live-with-it-for-years-to-come."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e210830","DOI":"10.1001\/jamanetworkopen.2021.0830","article-title":"Sequelae in Adults at 6 Months After COVID-19 Infection","volume":"4","author":"Logue","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref_13","first-page":"00542","article-title":"Persistent Symptoms 3 Months after a SARS-CoV-2 Infection: The Post-COVID-19 Syndrome?","volume":"6","author":"Delbressine","year":"2020","journal-title":"ERJ Open Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"n1648","DOI":"10.1136\/bmj.n1648","article-title":"Long Covid\u2014Mechanisms, Risk Factors, and Management","volume":"374","author":"Crook","year":"2021","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1136\/pgmj.64.753.559","article-title":"Post-Infectious Disease Syndrome","volume":"64","author":"Bannister","year":"1988","journal-title":"Postgrad. Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2102245","DOI":"10.1183\/13993003.02245-2021","article-title":"Long COVID: To Investigate Immunological Mechanisms and Sex\/Gender Related Aspects as Fundamental Steps for Tailored Therapy","volume":"59","author":"Ortona","year":"2022","journal-title":"Eur. Respir. J"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"698169","DOI":"10.3389\/fmicb.2021.698169","article-title":"Long COVID or Post-Acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms","volume":"12","author":"Proal","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/j.cell.2022.01.014","article-title":"Multiple Early Factors Anticipate Post-Acute COVID-19 Sequelae","volume":"185","author":"Su","year":"2022","journal-title":"Cell"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.immuni.2022.01.017","article-title":"Immuno-Proteomic Profiling Reveals Aberrant Immune Cell Regulation in the Airways of Individuals with Ongoing Post-COVID-19 Respiratory Disease","volume":"55","author":"Vijayakumar","year":"2022","journal-title":"Immunity"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"111308","DOI":"10.1016\/j.nut.2021.111308","article-title":"Altered Tryptophan Absorption and Metabolism Could Underlie Long-Term Symptoms in Survivors of Coronavirus Disease 2019 (COVID-19)","volume":"90","year":"2021","journal-title":"Nutrition"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2174\/1567202054368326","article-title":"Role of Kynurenines in the Central and Peripherial Nervous Systems","volume":"2","author":"Nemeth","year":"2005","journal-title":"CNR"},{"key":"ref_22","unstructured":"CDC (2022, June 22). Exposome and Exposomics | NIOSH | CDC, Available online: https:\/\/www.cdc.gov\/niosh\/topics\/exposome\/default.html."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"La Rosa, P.S., Brooks, J.P., Deych, E., Boone, E.L., Edwards, D.J., Wang, Q., Sodergren, E., Weinstock, G., and Shannon, W.D. (2012). Hypothesis Testing and Power Calculations for Taxonomic-Based Human Microbiome Data. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0052078"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Nyamundanda, G., Gormley, I.C., Fan, Y., Gallagher, W.M., and Brennan, L. (2013). MetSizeR: Selecting the Optimal Sample Size for Metabolomic Studies Using an Analysis Based Approach. BMC Bioinform., 14.","DOI":"10.1186\/1471-2105-14-338"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5179","DOI":"10.1021\/acs.analchem.6b00188","article-title":"Power Analysis and Sample Size Determination in Metabolic Phenotyping","volume":"88","author":"Blaise","year":"2016","journal-title":"Anal. Chem."},{"key":"ref_26","unstructured":"World Health Organization (2020). WHO R&D Blueprint Novel Coronavirus COVID-19 Therapeutic Trial Synopsis, World Health Organization."},{"key":"ref_27","unstructured":"RIVM (2022, June 30). Variants of the Coronavirus SARS-CoV-2. Available online: https:\/\/www.rivm.nl\/en\/coronavirus-covid-19\/virus\/variants."},{"key":"ref_28","unstructured":"CDC (2022, June 06). Long COVID or Post-COVID Conditions, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/long-term-effects\/index.html."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3395","DOI":"10.7150\/ijms.50568","article-title":"Chest CT Abnormalities in COVID-19: A Systematic Review","volume":"18","author":"Ghayda","year":"2021","journal-title":"Int. J. Med. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"221806","DOI":"10.1148\/radiol.221806","article-title":"Long-Term Lung Abnormalities Associated with COVID-19 Pneumonia","volume":"306","author":"Kanne","year":"2022","journal-title":"Radiology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12995-021-00337-9","article-title":"The Impact of Post-COVID-Syndrome on Functioning\u2014Results from a Community Survey in Patients after Mild and Moderate SARS-CoV-2-Infections in Germany","volume":"16","author":"Sturm","year":"2021","journal-title":"J. Occup. Med. Toxicol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e826","DOI":"10.1093\/cid\/ciab103","article-title":"Patients With Uncomplicated Coronavirus Disease 2019 (COVID-19) Have Long-Term Persistent Symptoms and Functional Impairment Similar to Patients with Severe COVID-19: A Cautionary Tale During a Global Pandemic","volume":"73","author":"Jacobson","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1126\/science.aaa5082","article-title":"Flexibility for Specificity","volume":"347","author":"Davis","year":"2015","journal-title":"Science"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1136\/thoraxjnl-2020-216086","article-title":"Patient Outcomes after Hospitalisation with COVID-19 and Implications for Follow-up: Results from a Prospective UK Cohort","volume":"76","author":"Arnold","year":"2021","journal-title":"Thorax"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1002\/acn3.51570","article-title":"Evolution of Neurologic Symptoms in Non-hospitalized COVID-19 \u201cLong Haulers\u201d","volume":"9","author":"Ali","year":"2022","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"611.e9","DOI":"10.1016\/j.cmi.2021.11.002","article-title":"Female Gender Is Associated with Long COVID Syndrome: A Prospective Cohort Study","volume":"28","author":"Bai","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e1247","DOI":"10.1016\/S2214-109X(22)00286-8","article-title":"Post-COVID-19 Condition 3 Months after Hospitalisation with SARS-CoV-2 in South Africa: A Prospective Cohort Study","volume":"10","author":"Dryden","year":"2022","journal-title":"Lancet Glob. Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1089\/jwh.2021.0411","article-title":"Sex-Related Differences in Long-COVID-19 Syndrome","volume":"31","author":"Goldoni","year":"2022","journal-title":"J. Women\u2019s Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/s41591-021-01292-y","article-title":"Attributes and Predictors of Long COVID","volume":"27","author":"Sudre","year":"2021","journal-title":"Nat. Med."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"the European Network on ME\/CFS (EUROMENE), Rasa, S., Nora-Krukle, Z., Henning, N., Eliassen, E., Shikova, E., Harrer, T., Scheibenbogen, C., Murovska, M., and Prusty, B.K. (2018). Chronic Viral Infections in Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS). J. Transl. Med., 16, 268.","DOI":"10.1186\/s12967-018-1644-y"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"5104","DOI":"10.1038\/s41467-022-32507-6","article-title":"A Prospective Observational Study of Post-COVID-19 Chronic Fatigue Syndrome Following the First Pandemic Wave in Germany and Biomarkers Associated with Symptom Severity","volume":"13","author":"Kedor","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e2036142","DOI":"10.1001\/jamanetworkopen.2020.36142","article-title":"Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge","volume":"4","author":"Bellan","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e406","DOI":"10.1016\/S2468-2667(22)00042-1","article-title":"Acute COVID-19 Severity and Mental Health Morbidity Trajectories in Patient Populations of Six Nations: An Observational Study","volume":"7","author":"Lovik","year":"2022","journal-title":"Lancet Public Health"},{"key":"ref_44","unstructured":"Trimbos Instituut (2022, July 07). Neerslachtiger, Meer Slaapproblemen En Gedachten Aan de Dood Door Corona. Available online: https:\/\/www.trimbos.nl\/actueel\/nieuws\/neerslachtiger-meer-slaapproblemen-en-gedachten-aan-de-dood-door-corona\/."},{"key":"ref_45","unstructured":"Centraal Bureau voor de Statistiek (2022, July 08). Meer Volwassenen Met Ernstig Overgewicht Tevreden Met Gewicht. Available online: https:\/\/www.cbs.nl\/nl-nl\/nieuws\/2021\/34\/meer-volwassenen-met-ernstig-overgewicht-tevreden-met-gewicht."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1038\/s41746-021-00484-7","article-title":"Mapping Each Pre-Existing Condition\u2019s Association to Short-Term and Long-Term COVID-19 Complications","volume":"4","author":"Venkatakrishnan","year":"2021","journal-title":"npj Digit. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2263","DOI":"10.1016\/S0140-6736(22)00941-2","article-title":"Risk of Long COVID Associated with Delta versus Omicron Variants of SARS-CoV-2","volume":"399","author":"Antonelli","year":"2022","journal-title":"Lancet"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"So, M., Kabata, H., Fukunaga, K., Takagi, H., and Kuno, T. (2021). Radiological and Functional Lung Sequelae of COVID-19: A Systematic Review and Meta-Analysis. BMC Pulm. Med., 21.","DOI":"10.1186\/s12890-021-01463-0"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Lehmann, A., Gysan, M., Bernitzky, D., Bal, C., Prosch, H., Zehetmayer, S., Milos, R.-I., Vonbank, K., Pohl, W., and Idzko, M. (2022). Comparison of Pulmonary Function Test, Diffusion Capacity, Blood Gas Analysis and CT Scan in Patients with and without Persistent Respiratory Symptoms Following COVID-19. BMC Pulm. Med., 22.","DOI":"10.1186\/s12890-022-01987-z"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Shahid, A., Wilkinson, K., Marcu, S., and Shapiro, C.M. (2011). STOP, THAT and One Hundred Other Sleep Scales, Springer.","DOI":"10.1007\/978-1-4419-9893-4"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1080\/21641846.2019.1653471","article-title":"The DePaul Symptom Questionnaire-2: A Validation Study","volume":"7","author":"Bedree","year":"2019","journal-title":"Fatigue Biomed. Health Behav."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jad.2021.11.031","article-title":"Long-Term Effects of COVID-19 on Mental Health: A Systematic Review","volume":"299","author":"Bourmistrova","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1093\/occmed\/kqu024","article-title":"The Hospital Anxiety and Depression Scale","volume":"64","author":"Stern","year":"2014","journal-title":"Occup. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"478","DOI":"10.3109\/09638288.2011.608148","article-title":"Validity of the Utrecht Scale for Evaluation of Rehabilitation-Participation","volume":"34","author":"Post","year":"2012","journal-title":"Disabil. Rehabil."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.jval.2012.02.008","article-title":"Interim Scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L Value Sets","volume":"15","author":"Janssen","year":"2012","journal-title":"Value Health"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s11136-009-9496-9","article-title":"Development of Physical and Mental Health Summary Scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Items","volume":"18","author":"Hays","year":"2009","journal-title":"Qual. Life Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1007\/s11606-016-3703-5","article-title":"The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample","volume":"31","author":"Prins","year":"2016","journal-title":"J. Gen. Intern. Med."},{"key":"ref_58","first-page":"366","article-title":"Measuring Self-Determination Motivation in a Physical Fitness Setting: Validation of the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) in a Spanish Sample","volume":"47","author":"Murcia","year":"2007","journal-title":"J. Sport. Med. Phys. Fit."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1023\/B:MOEM.0000040154.40922.14","article-title":"Why Do You Regulate What You Eat? Relationships Between Forms of Regulation, Eating Behaviors, Sustained Dietary Behavior Change, and Psychological Adjustment","volume":"28","author":"Pelletier","year":"2004","journal-title":"Motiv. Emot."},{"key":"ref_60","unstructured":"SODAQ (2022, June 06). SODAQ Snifferbike\u2014SODAQ. Available online: https:\/\/old.sodaq.com\/sodaq-snifferbike\/."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"3327","DOI":"10.1021\/es405022f","article-title":"Silicone Wristbands as Personal Passive Samplers","volume":"48","author":"Kincl","year":"2014","journal-title":"Environ. Sci. Technol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1002\/jcsm.12219","article-title":"A Randomized Clinical Trial Investigating the Efficacy of Targeted Nutrition as Adjunct to Exercise Training in COPD: Targeted Nutrition in COPD Patients with Low Muscle Mass","volume":"8","author":"Rutten","year":"2017","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.clnu.2019.03.001","article-title":"Clinical Outcome and Cost-Effectiveness of a 1-Year Nutritional Intervention Programme in COPD Patients with Low Muscle Mass: The Randomized Controlled NUTRAIN Trial","volume":"39","author":"Boland","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1080\/01635581.2020.1773873","article-title":"Targeted Medical Nutrition in Pre-Cachectic Patients with Non-Small-Cell Lung Cancer: A Subgroup Analysis","volume":"73","author":"Laviano","year":"2021","journal-title":"Nutr. Cancer"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1002\/jcsm.12228","article-title":"Targeted Medical Nutrition for Cachexia in Chronic Obstructive Pulmonary Disease: A Randomized, Controlled Trial: Cachexia in COPD: TMN RCT","volume":"9","author":"Calder","year":"2018","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1080\/01635581.2019.1634746","article-title":"Safety and Tolerability of Targeted Medical Nutrition for Cachexia in Non-Small-Cell Lung Cancer: A Randomized, Double-Blind, Controlled Pilot Trial","volume":"72","author":"Laviano","year":"2020","journal-title":"Nutr. Cancer"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/jpen.1440","article-title":"GLIM Criteria for the Diagnosis of Malnutrition: A Consensus Report From the Global Clinical Nutrition Community","volume":"43","author":"Jensen","year":"2019","journal-title":"J. Parenter. Enter. Nutr."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/7\/1060\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:02:43Z","timestamp":1760126563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/7\/1060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,28]]},"references-count":67,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["jpm13071060"],"URL":"https:\/\/doi.org\/10.3390\/jpm13071060","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,28]]}}}