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‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19
  1. Swapna Mandal1,
  2. Joseph Barnett2,
  3. Simon E Brill1,
  4. Jeremy S Brown3,4,
  5. Emma K Denneny4,
  6. Samanjit S Hare2,
  7. Melissa Heightman4,
  8. Toby E Hillman4,
  9. Joseph Jacob5,6,
  10. Hannah C Jarvis1,
  11. Marc C I Lipman1,3,
  12. Sindhu B Naidu1,
  13. Arjun Nair6,
  14. Joanna C Porter3,4,
  15. Gillian S Tomlinson4,7,
  16. John R Hurst1,3
  17. ARC Study Group
    1. 1 Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK
    2. 2 Department of Radiology, Royal Free London NHS Foundation Trust, London, UK
    3. 3 UCL Respiratory, University College London, London, UK
    4. 4 Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, UK
    5. 5 Centre for Medical Image Computing, University College London, London, UK
    6. 6 Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK
    7. 7 Infection and Immunity, University College London, London, UK
    1. Correspondence to Professor John R Hurst, UCL Respiratory, University College London, London, London NW3 2PF, UK; j.hurst{at}


    Large numbers of people are being discharged from hospital following COVID-19 without assessment of recovery. In 384 patients (mean age 59.9 years; 62% male) followed a median 54 days post discharge, 53% reported persistent breathlessness, 34% cough and 69% fatigue. 14.6% had depression. In those discharged with elevated biomarkers, 30.1% and 9.5% had persistently elevated d-dimer and C reactive protein, respectively. 38% of chest radiographs remained abnormal with 9% deteriorating. Systematic follow-up after hospitalisation with COVID-19 identifies the trajectory of physical and psychological symptom burden, recovery of blood biomarkers and imaging which could be used to inform the need for rehabilitation and/or further investigation.

    • viral infection
    • respiratory infection

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    • Collaborators The ARC Study Group: Aishah Ahmed, Asia Ahmed, Andrea Bangay, Izumi Barbor, Meg Barber, James Batty, Thea Buchan, Tom Burns, Alisha Chauhan, Ben Cooper, Roise Dudley, Mark Duncan, Nada Elsaid, Rebecca Evans, Samuel Flatau, Lydia Gabriel, James Goldring, Heather Groombridge, Liam Healy, Neel Jain, Afshan Khan, Camila Nagoda Niklewicz, Ezgi Ozcan, Preena Patel, Shivani Patel, Alexander Procter, Alice Ring, James Robertson, Portia Sagoe, Anita Saigal, George Seligmann, Runil Shah, Magali Taylor, Andrew Wendruff and Hannah Woodcock.

    • Contributors SM, SEB, JSB, MH, TEH, MCIL, JCP and JRH developed the clinical follow-up protocol. JB, JJ, SSH and AN developed and led the radiology protocols and analysis. SM, EKD, MH, HCJ, SBN and GST delivered and supported the follow-up process at three hospital sites. SM led the initial data analysis. JRH developed the first draft of the manuscript. All authors revised the manuscript for important intellectual content and approved the final version for submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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