Prevalence of physical frailty, including risk factors, up to 1 year after hospitalisation for COVID-19 in the UK: a multicentre, longitudinal cohort study
Hamish McAuley(University of Leicester), Rachael A Evans(University of Leicester), Charlotte E. Bolton(Nottingham University Hospitals NHS Trust), Christopher E. Brightling(University of Leicester), James D. Chalmers(University of Dundee), Annemarie B Docherty(University of Edinburgh), Omer Elneima(University of Leicester), Paul L. Greenhaff(University of Nottingham), Ayushman Gupta(University of Nottingham), Victoria Harris(University of Leicester), Ewen M. Harrison(University of Edinburgh), Ling‐Pei Ho(University of Oxford), Alex Horsley(University of Manchester), Linzy Houchen‐Wolloff(University of Leicester), Caroline J. Jolley(King's College London), Olivia C. Leavy(University of Leicester), Nazir Lone(NHS Lothian), William D‐C Man(King's College London), Michael Marks(Royal London Hospital), Dhruv Parekh(University Hospitals Birmingham NHS Foundation Trust), Krisnah Poinasamy(Asthma UK), Jennifer K Quint(Imperial College London), Betty Raman(University of Oxford), Matthew Richardson(University of Leicester), Ruth Saunders(University of Leicester), Marco Sereno(University of Leicester), Aarti Shikotra(University of Leicester), Amisha Singapuri(University of Leicester), Sally Singh(University of Leicester), Michael Steiner(University of Leicester), Ai Lyn Tan(University of Leeds), Louise V. Wain(University of Leicester), Carly Welch(University of Birmingham), Julie Whitney(King's College London), Miles D. Witham(Newcastle upon Tyne Hospitals NHS Foundation Trust), Janet M. Lord(University of Birmingham), Neil Greening(University of Leicester), Kathryn M. Abel(University of Leicester), Huzaifa Adamali(Newcastle upon Tyne Hospitals NHS Foundation Trust), Davies Adeloye(University of Birmingham), O Adeyemi(University of Birmingham), R Adrego(University of Leicester), L A Aguilar Jimenez, Shazaad Ahmad(Newcastle upon Tyne Hospitals NHS Foundation Trust), Nafees Haider(University of Leicester), Rizwan Ahmed(University of Leicester), N Ahwireng(University of Leicester), Mark Ainsworth(Newcastle upon Tyne Hospitals NHS Foundation Trust), B Al-Sheklly(University of Oxford), A Alamoudi, Mohammad Ali(Newcastle upon Tyne Hospitals NHS Foundation Trust), M Aljaroof(Newcastle upon Tyne Hospitals NHS Foundation Trust), A.M. All(University of Leicester), Louise Allan(University of Leicester), R Allen, L. Allerton(University of Leicester), Lynne Allsop(University of Leicester), P. Almeida(University of Leicester), Doris Altmann(University of Birmingham), Maria Alvarez Corral(Newcastle upon Tyne Hospitals NHS Foundation Trust), S Amoils(Newcastle upon Tyne Hospitals NHS Foundation Trust), Debra Anderson(University of Birmingham), Chrystalina A. Antoniades(University of Birmingham), G. Arbane(University of Leicester), Ana Arias, Chérie Armour(University of Birmingham), Lará Armstrong(University of Leicester), Natalie Armstrong(University of Leicester), David Arnold(University of Birmingham), H Arnold(Newcastle upon Tyne Hospitals NHS Foundation Trust), Abdul Ashish, Andrew Ashworth, Mark Ashworth(Newcastle upon Tyne Hospitals NHS Foundation Trust), S Aslani(Newcastle upon Tyne Hospitals NHS Foundation Trust), H Assefa-Kebede(Newcastle upon Tyne Hospitals NHS Foundation Trust), Catherine Atkin(University of Birmingham), Philip A. Atkin(University of Leicester), Raminder Aul(University of Nottingham), Htin Aung(Newcastle upon Tyne Hospitals NHS Foundation Trust), Luke Austin(University of Leicester), Cristina Avram(University of Birmingham), A Ayoub, Marta Babores(Newcastle upon Tyne Hospitals NHS Foundation Trust), Rob Baggott(University of Leicester), J. Bagshaw(University of Leicester), David Baguley(University of Birmingham), L. Charles Bailey(University of Leicester), J. Kenneth Baillie, S. Bain(Newcastle upon Tyne Hospitals NHS Foundation Trust), M Bakali(Newcastle upon Tyne Hospitals NHS Foundation Trust), M Bakau(Newcastle upon Tyne Hospitals NHS Foundation Trust), Eileen Baldry(University of Leicester), David Baldwin(University of Birmingham), Molly M Baldwin(Newcastle upon Tyne Hospitals NHS Foundation Trust), Clive Ballard(University of Birmingham), Amitava Banerjee, B. Bang(University of Oxford), Ruth E Barker(University of Leicester), L Barman(University of Leicester), Shaney Barratt(Newcastle upon Tyne Hospitals NHS Foundation Trust), Fiona Barrett(Imperial College London), D Basire(University of Birmingham), N Basu(University of Leicester), M. Bates(Newcastle upon Tyne Hospitals NHS Foundation Trust), Andrew Bates, Rachel L. Batterham(University of Leicester), Helen Baxendale(Newcastle upon Tyne Hospitals NHS Foundation Trust), Hannah Bayes(Newcastle upon Tyne Hospitals NHS Foundation Trust), Michael Beadsworth(Newcastle upon Tyne Hospitals NHS Foundation Trust), P Beckett(University of Leicester), M. Beggs(Newcastle upon Tyne Hospitals NHS Foundation Trust), M Begum(Newcastle upon Tyne Hospitals NHS Foundation Trust), Paul Beirne(University of Leicester), D Bell(University of Birmingham), Robert M. Bell(University of Leicester), Katherine Bennett(University of Leicester), Eva Beranová(University of Leicester), Areti Bermperi, A Berridge, Colin Berry(University of Birmingham), Sarah Betts(Newcastle upon Tyne Hospitals NHS Foundation Trust), Emily Bevan(University of Leicester), Kam Bhui(University of Leicester), M Bingham(Newcastle upon Tyne Hospitals NHS Foundation Trust), K Birchall(University of Leicester), Lisa Bishop(University of Leicester), Karen Bisnauthsing(University of Leicester), J Blaikely(University of Leicester), Angela Bloss, A Bolger, Charlotte E. Bolton(Nottingham University Hospitals NHS Trust), James Bonnington(University of Leicester), A Botkai, C Bourne(University of Birmingham), Michelle Bourne(Newcastle upon Tyne Hospitals NHS Foundation Trust), Kate Bramham(University of Leicester), L Brear(University of Leicester), Gerome Breen(University of Leicester), J Breeze(University of Leicester), Andrew Briggs, E Bright(University of Leicester), Christopher E. Brightling(University of Leicester), Simon Brill(Newcastle upon Tyne Hospitals NHS Foundation Trust), Khara Croswaite Brindle(University of Leicester), L. Broad(University of Leicester), A Broadley, C Brookes(University of Birmingham), Matthew R. Broome(Newcastle upon Tyne Hospitals NHS Foundation Trust), A. Brown, A. Brown, Jeremy Brown(University of Leicester), Jeremy Brown(University of Leicester), Jeremy Brown(University of Leicester), Martin M. Brown(Newcastle upon Tyne Hospitals NHS Foundation Trust), Martin M. Brown(Newcastle upon Tyne Hospitals NHS Foundation Trust), Victoria Tzortziou Brown(University Hospitals Birmingham NHS Foundation Trust), Traolach Brugha(University of Birmingham), Nigel J. Brunskill(University of Leicester), Maya H Buch(Newcastle upon Tyne Hospitals NHS Foundation Trust), Philip Buckley(University of Leicester), Anda Bularga, Edward T. Bullmore(University of Leicester), L. Burden(University of Leicester), Teresa Burdett(University of Birmingham), D Burn(University of Birmingham), G Burns(University of Leicester), Angus C. Burns, John Busby(University of Leicester), R. Butcher(University of Leicester), Adeel A. Butt, Suzanne Byrne(Newcastle upon Tyne Hospitals NHS Foundation Trust), Paula Cairns(University of Leicester), P C Calder, E Calvelo(University of Leicester), H Carborn(Newcastle upon Tyne Hospitals NHS Foundation Trust), Brittany Card(University of Oxford), Christine Carr(University of Birmingham), L. Carr(University of Leicester), Gail Carson(University of Leicester), P. Carter(University of Leicester), Anna Casey, Mark Philip Cassar(Newcastle upon Tyne Hospitals NHS Foundation Trust), Jorunn Pauline Cavanagh(University of Leicester), Manish Chablani(Newcastle upon Tyne Hospitals NHS Foundation Trust), Trudie Chalder(University of Birmingham), James D. Chalmers(University of Dundee), R C Chambers(University of Leicester), Francis K.L. Chan(Imperial College London), K.M. Channon, K Chapman(University of Leicester), A Charalambou, Nazia Chaudhuri(University of Leicester), Anna M. Checkley, Joe Jun Qiao Chen(University of Leicester), Yu Cheng(King's College London), L Chetham(University of Leicester), C Childs(University of Birmingham), Edwin R. Chilvers(University of Leicester), Hector Chinoy(Newcastle upon Tyne Hospitals NHS Foundation Trust), Amedeo Chiribiri, K Chong-James(University of Leicester), Gourab Choudhury(University of Leicester), Noura J. Choudhury(University of Leicester), Phil Chowienczyk(University of Leicester), C D C Christie(University of Birmingham), M Chrystal(Newcastle upon Tyne Hospitals NHS Foundation Trust), Diane Clark(University of Birmingham), Collin M. Clark(University of Birmingham), Jennifer Clarke(University of Leicester), Sara Clohisey(Newcastle upon Tyne Hospitals NHS Foundation Trust), G Coakley(University of Leicester), Z Coburn(NHS Lothian), S Coetzee(Newcastle upon Tyne Hospitals NHS Foundation Trust), Joby Cole(University of Leicester), Christopher M. Coleman(University of Birmingham), F Conneh(Imperial College London), David Connell(University of Birmingham), Bronwen Connolly(University of Oxford), L Connor(University of Leicester), A Cook, Brendan Cooper(University of Oxford), D. James Cooper(University of Leicester), Sheldon C. Cooper(Newcastle upon Tyne Hospitals NHS Foundation Trust), Debra Copeland(University of Birmingham), Tracey Cosier(University of Birmingham), M Coulding(Newcastle upon Tyne Hospitals NHS Foundation Trust), C Coupland(University of Birmingham), Eline G. M. Cox(University of Leicester), Tom Craig(University of Birmingham), Philippe Crisp(University of Leicester), D Cristiano(University of Birmingham), Michael G. Crooks, Adam Cross, I Cruz(University of Leicester), Paul Cullinan(University of Leicester), Daniel J. Cuthbertson(University of Birmingham), Luke Daines(University of Leicester), M Dalton(Newcastle upon Tyne Hospitals NHS Foundation Trust), Patricia Daly(University of Leicester), A Daniels, Paul Dark(University of Leicester), J Dasgin(University of Leicester), Abel P. David, C. David(University of Birmingham), Elin Haf Davies(University of Leicester), Ffyon Davies(Imperial College London), Gwyneth A. Davies(University of Leicester), Gwyneth A. Davies(University of Leicester), Katherine Davies(University of Leicester), Matthew Davies, Jennifer Dawson(University of Leicester), E Daynes(University of Leicester), Anthony De Soyza, B Deakin(University of Oxford), Andrew Deans, C Deas(University of Birmingham), J Deery(University of Leicester), Sylviane Defres(Newcastle upon Tyne Hospitals NHS Foundation Trust), Amanda Dell, K Dempsey(University of Leicester), Emma Denneny(University of Leicester), John Dennis(University of Leicester), Amy Dewar, R Dharmagunawardena(University of Leicester), N Diar-Bakerly(University of Leicester), Chris Dickens(University of Birmingham), A Dipper, Sarah Diver(Newcastle upon Tyne Hospitals NHS Foundation Trust), S N Diwanji(Asthma UK), Michael J. Dixon(Newcastle upon Tyne Hospitals NHS Foundation Trust), Ratko Djukanović(University of Leicester), Hannah Dobson(Newcastle upon Tyne Hospitals NHS Foundation Trust), Susan L. Dobson(University of Manchester), Annemarie B Docherty(University of Edinburgh), A Donaldson, Tim Dong(University of Birmingham), Natalie Dormand(University of Leicester), Andrew Dougherty, Rowan Dowling(University of Leicester), S Drain(Newcastle upon Tyne Hospitals NHS Foundation Trust), K Draxlbauer(University of Leicester), K. Drury(University of Leicester), H.J.C. drury(University of Leicester), P Dulawan(University of Leicester), A Dunleavy, S Dunn(Newcastle upon Tyne Hospitals NHS Foundation Trust), C. Dupont(University of Birmingham), J Earley(University of Leicester), Nicholas Easom(University of Leicester), Carlos Echevarria(University of Birmingham), Sarah Edwards(Newcastle upon Tyne Hospitals NHS Foundation Trust), Charlotte L. Edwardson(University of Birmingham), H El-Taweel(Newcastle upon Tyne Hospitals NHS Foundation Trust), Angela Elliott, Katharine Elliott(University of Leicester), Y Ellis(King's College London), A Elmer, Omer Elneima(University of Leicester), D Evans(University of Leicester), Helen Evans(University of Leicester), Jonathan Evans(University of Leicester), Rachael A Evans(University of Leicester), R.A. Evans(University of Leicester), Rhodri Evans(University of Leicester), Teriann Evans(University of Birmingham), C Evenden(University of Leicester), Lynsey Evison(University of Leicester), Laura Fabbri(Newcastle upon Tyne Hospitals NHS Foundation Trust), Sara Fairbairn, Andrea D. Fairman(University of Leicester), K Fallon(University of Birmingham), David Faluyi(University of Birmingham), C Favager(University of Birmingham), T Fayzan(University of Leicester), J. Featherstone(University of Birmingham), Tim Felton(University of Leicester), J Finch(Newcastle upon Tyne Hospitals NHS Foundation Trust), Simon J. Finney(University of Leicester), J Finnigan(University of Leicester), Lucy Finnigan(Newcastle upon Tyne Hospitals NHS Foundation Trust), Helen L. Fisher(Newcastle upon Tyne Hospitals NHS Foundation Trust), Simon Fletcher(University of Leicester), R Flockton(Newcastle upon Tyne Hospitals NHS Foundation Trust), M. G. Flynn(Newcastle upon Tyne Hospitals NHS Foundation Trust), H Foot(University of Birmingham), David Foote, James D. Ford(University of Birmingham), Daniel Forton(University of Leicester), E Fraile(University of Birmingham), C Francis(University of Leicester), Rebecca Francis(Newcastle upon Tyne Hospitals NHS Foundation Trust), Sarah Francis, Adam Frankel(University of Leicester), Emily Fraser(University of Leicester), Robert C. Free(University of Leicester), Nigel French(University of Manchester), Xiaotong Fu(University of Leicester), Jonathan Fuld(University of Leicester), James Furniss(University of Leicester), L. Garner(University of Leicester), Nandan Gautam, J R Geddes(University of Leicester), J. George(University of Leicester), P M George(Newcastle upon Tyne Hospitals NHS Foundation Trust), Michael Gibbons(Newcastle upon Tyne Hospitals NHS Foundation Trust), Michael Gill(University of Leicester), L Gilmour(Imperial College London), Fergus Gleeson(University of Leicester), J Glossop(Newcastle upon Tyne Hospitals NHS Foundation Trust), S. W. Glover(University of Leicester), Nigel Goodman(University of Birmingham), C Goodwin(University of Oxford), Bibek Gooptu(Newcastle upon Tyne Hospitals NHS Foundation Trust), Howard S. Gordon(University of Birmingham), T Gorsuch(Newcastle upon Tyne Hospitals NHS Foundation Trust), M Greatorex(University of Nottingham), Paul L. Greenhaff(University of Nottingham), William Greenhalf, A Greenhalgh(University of Leicester), Neil Greening(University of Leicester), John P. Greenwood(Newcastle upon Tyne Hospitals NHS Foundation Trust), H Gregory(University of Leicester), R. Gregory(University of Birmingham), D Grieve(University of Birmingham), Denise Griffin(University of Leicester), Lori Griffiths(Newcastle upon Tyne Hospitals NHS Foundation Trust), A-M Guerdette(University of Oxford), B. Guillen Guio(Newcastle upon Tyne Hospitals NHS Foundation Trust), Mahitha Gummadi(University of Nottingham), Ayush Gupta(University of Nottingham), Sambasivarao Gurram(University of Leicester), Elspeth Guthrie(NHS Lothian), Z Guy, H Henson(University of Leicester), Kate Hadley, A Haggar(University of Leicester), Kirsten Hainey(University of Oxford), Brigid Hairsine(University of Leicester), Pranabashis Haldar(University of Leicester), Isabella Hall(University of Leicester), L Hall(Newcastle upon Tyne Hospitals NHS Foundation Trust), Mark Halling‐Brown(University of Leicester), R Hamil, A Hancock(University of Leicester), Kerry Hancock(Asthma UK), Neil A. Hanley(Newcastle upon Tyne Hospitals NHS Foundation Trust), Sulaimaan Haq(University of Leicester), Hayley Hardwick(University of Leicester), Elaine Hardy(University of Birmingham), T Hardy(University of Oxford), Beverley Hargadon(University of Leicester), Kevin J. Harrington(University of Edinburgh), Emma Harris(University of Edinburgh), Victoria Harris(University of Leicester), E.M. Harrison(University of Leicester), Phillippa Harrison, Nicholas Hart(Newcastle upon Tyne Hospitals NHS Foundation Trust), A Harvey(Newcastle upon Tyne Hospitals NHS Foundation Trust), M Harvey(University of Leicester), M Harvie(Newcastle upon Tyne Hospitals NHS Foundation Trust), Lynn Haslam‐Larmer(University of Leicester), May Havinden-Williams(University of Leicester), Jason E. Hawkes(University of Leicester), N Hawkings, J Haworth(Newcastle upon Tyne Hospitals NHS Foundation Trust), Adrian Hayday(University of Leicester), M Haynes(University of Birmingham), Jon Hazeldine(University of Nottingham), T Hazelton(University of Birmingham), Liam G. Heaney, Cheryl Heeley(Newcastle upon Tyne Hospitals NHS Foundation Trust), Jonathan L. Heeney(Newcastle upon Tyne Hospitals NHS Foundation Trust), Melissa Heightman(Newcastle upon Tyne Hospitals NHS Foundation Trust), Simon Heller(University of Leicester), Morag Henderson(Newcastle upon Tyne Hospitals NHS Foundation Trust), L Hesselden(University Hospitals Birmingham NHS Foundation Trust), Melissa Hewitt(University of Birmingham), V Highett(University of Birmingham), Toby Hillman(University of Leicester), T Hiwot, Ling‐Pei Ho(Newcastle upon Tyne Hospitals NHS Foundation Trust), A Hoare(University of Leicester), M Hoare(University of Leicester), J Hockridge, P Hogarth(Newcastle upon Tyne Hospitals NHS Foundation Trust), A Holbourn(University of Leicester), Sara Holden(University of Birmingham), Luke Holdsworth(Newcastle upon Tyne Hospitals NHS Foundation Trust), D Holgate(University of Leicester), M Holland(University of Leicester), L Holloway(Newcastle upon Tyne Hospitals NHS Foundation Trust), K. Holmes(University of Oxford), Manisha Holmes(University of Leicester), B Holroyd-Hind, L Holt(University of Manchester), Anil Hormis, Alex Horsley(Newcastle upon Tyne Hospitals NHS Foundation Trust), Akram A. Hosseini(University of Leicester), Matthew Hotopf(University of Leicester), Linzy Houchen‐Wolloff(University of Leicester), Kirsten Howard, Luke Howard(University of Leicester), Alice Howell, E Hufton(University of Leicester), Alun D. Hughes(University of Leicester), Joel W. Hughes, R Hughes(University of Leicester), A Humphries(University of Leicester), Nathan T. M. Huneke(University of Leicester), E Hurditch(Newcastle upon Tyne Hospitals NHS Foundation Trust), John R. Hurst(University of Birmingham), Masud Husain(University of Leicester), Tracy Hussell(Newcastle upon Tyne Hospitals NHS Foundation Trust), J Hutchinson(Imperial College London), Wadah Ibrahim(University of Leicester), F Ilyas(University of Leicester), J Ingham(University of Birmingham), L Ingram(University of Leicester), D Ionita(University of Leicester), K Isaacs(University of Birmingham), Khalida Ismail(University of Leicester), Thomas Jackson(University of Dundee), Joseph Jacob(Newcastle upon Tyne Hospitals NHS Foundation Trust), W Y James(University of Birmingham), Wooyoung Jang(University of Leicester), C Jarman(Newcastle upon Tyne Hospitals NHS Foundation Trust), Ian Jarrold(University of Leicester), Hannah Jarvis(University of Oxford), R Jastrub, B Jayaraman(University of Leicester), Gísli Jenkins(University of Leicester), Peter Jezzard(University of Birmingham), K Jiwa(Newcastle upon Tyne Hospitals NHS Foundation Trust), Candace Johnson(University of Birmingham), Steven Johnson(King's College London), D Johnston(University of Birmingham), Caroline J. Jolley(University of Leicester), D Jones(Newcastle upon Tyne Hospitals NHS Foundation Trust), Graeme Jones(Newcastle upon Tyne Hospitals NHS Foundation Trust), H. Jones(University of Leicester), H. Jones(University of Leicester), Ian A. Jones, L Jones(Newcastle upon Tyne Hospitals NHS Foundation Trust), Mark G. Jones(Newcastle upon Tyne Hospitals NHS Foundation Trust), S Jones(University of Birmingham), S Jose(University of Leicester), T Kabir(University Hospitals Birmingham NHS Foundation Trust), Georgios Kaltsakas(University of Leicester), Vicky Kamwa(Newcastle upon Tyne Hospitals NHS Foundation Trust), N. Kanellakis(NHS Lothian), S Kaprowska(University of Leicester), Zunaira Kausar(Newcastle upon Tyne Hospitals NHS Foundation Trust), Natalie Keenan(University of Leicester), Sadie Kelly(Newcastle upon Tyne Hospitals NHS Foundation Trust), Graham J. Kemp(Newcastle upon Tyne Hospitals NHS Foundation Trust), S Kerr(University of Leicester), Helen Kerslake(Imperial College London), A L Key(University of Leicester), Fasihul Khan(Newcastle upon Tyne Hospitals NHS Foundation Trust), Kamlesh Khunti(University of Oxford), Susan Kilroy(University of Birmingham), B. King(University of Leicester), C King(University of Leicester), L. Kingham(University of Leicester), Jodie Kirk(University of Leicester), Pádraig T. Kitterick(University of Leicester), Paul Klenerman(Newcastle upon Tyne Hospitals NHS Foundation Trust), Lucy Knibbs, Susan Knight(University of Birmingham), A. Knighton(Newcastle upon Tyne Hospitals NHS Foundation Trust), Onn Min Kon, Samantha S.C. Kon(Newcastle upon Tyne Hospitals NHS Foundation Trust), Samantha S.C. Kon, S. Koprowska(University of Leicester), Ania Korszun(University of Birmingham), Ivan Koychev(University of Leicester), C Kurasz(University of Birmingham), P Kurupati(Newcastle upon Tyne Hospitals NHS Foundation Trust), Charles Laing(University of Leicester), H. Lamlum(University of Birmingham), G Landers(University of Birmingham), Claudia Langenberg(University of Leicester), Daniel Lasserson, Lara Lavelle-Langham(University of Birmingham), Alison M. Lawrie(University of Birmingham), Claire Lawson, Claire Lawson(University of Leicester), A Layton(University of Leicester), A Lea(University of Birmingham), Olivia C. Leavy(University of Leicester), D. Lee(University of Leicester), J.-H. Lee(University of Leicester), E. Lee(University of Leicester), K. Leitch(University of Birmingham), R Lenagh(University of Leicester), Daniel Lewis, J. R. Lewis(University Hospitals Birmingham NHS Foundation Trust), Keir Lewis(University of Leicester), Virginia Lewis(King's College London), N Lewis-Burke(University of Birmingham), X. Li(University of Leicester), Teresa Light(Newcastle upon Tyne Hospitals NHS Foundation Trust), Liz Lightstone(University of Leicester), W. Lilaonitkul(Newcastle upon Tyne Hospitals NHS Foundation Trust), L. Lim, S Linford(Newcastle upon Tyne Hospitals NHS Foundation Trust), Anne Lingford‐Hughes(University of Leicester), Marc Lipman, Kamal Liyanage(Newcastle upon Tyne Hospitals NHS Foundation Trust), Adam Lloyd(University of Birmingham), Sarah Logan(NHS Lothian), David A. Lomas(University of Leicester), Nazir Lone(NHS Lothian), Ronda Loosley(Newcastle upon Tyne Hospitals NHS Foundation Trust), Janet M. Lord(Newcastle upon Tyne Hospitals NHS Foundation Trust), Harpreet Lota, Wayne Lovegrove(University of Leicester), Alice Lucey, Elena Lukaschuk(University of Birmingham), A Lye(Newcastle upon Tyne Hospitals NHS Foundation Trust), C. Lynch(University of Leicester), Steven MacDonald(University of Leicester), Guy MacGowan(University of Leicester), Irene Macharia(University of Leicester), J Mackie(Newcastle upon Tyne Hospitals NHS Foundation Trust), L Macliver(University of Leicester), S Madathil(University of Leicester), G Madzamba, N Magee(University of Leicester), M M Magtoto(University of Leicester), N Mairs(University of Leicester), Nauman Majeed(Imperial College London), Eugene O. Major(Newcastle upon Tyne Hospitals NHS Foundation Trust), Flora Malein(University of Leicester), Michael H. Malim(King's College London), Georgia Mallison(Newcastle upon Tyne Hospitals NHS Foundation Trust), William D‐C Man(University of Leicester), Sema Mandal(University of Birmingham), Kenneth Mangion(University of Leicester), Charlotte Manisty(University of Leicester), R Manley(Newcastle upon Tyne Hospitals NHS Foundation Trust), Keith L. March(University of Leicester), Stefan J. Marciniak(Newcastle upon Tyne Hospitals NHS Foundation Trust), Pietro Marino(Royal London Hospital), M Mariveles(University of Leicester), Michael Marks(Royal London Hospital), E Marouzet(University of Oxford), S. Marsh(Newcastle upon Tyne Hospitals NHS Foundation Trust), Ben G. Marshall(University of Leicester), Michael S. Marshall, James Martín(Royal London Hospital), Adrian R. Martineau(University of Leicester), Leonardo Martín Vásquez Martínez(University of Birmingham), Nick Maskell(Newcastle upon Tyne Hospitals NHS Foundation Trust), Darwin Matila(University of Leicester), Wadzanai Matimba-Mupaya, Lauren Matthews(Newcastle upon Tyne Hospitals NHS Foundation Trust), A Mbuyisa(Newcastle upon Tyne Hospitals NHS Foundation Trust), Stephen P. McAdoo, R. Hamish McAllister‐Williams(University of Leicester), Angela McArdle(University of Birmingham), P McArdle(University of Oxford), D McAulay(University of Leicester), Gerry P McCann(Newcastle upon Tyne Hospitals NHS Foundation Trust), Jacqueline McCormick(University of Leicester), W McCormick(University of Leicester), P McCourt(University of Birmingham), Lorcan McGarvey(University of Leicester), Christopher McGee(University of Leicester), Kirsty McGee(University of Leicester), J McGinness, K McGlynn(Newcastle upon Tyne Hospitals NHS Foundation Trust), A McGovern, Heather McGuinness(University of Leicester), Iain B. McInnes(University of Leicester), J McIntosh(University of Leicester), E McIvor(University of Leicester), K McIvor, L McLeavey, Anne McMahon(University of Leicester), Michael McMahon(University of Birmingham), Liam McMorrow(Newcastle upon Tyne Hospitals NHS Foundation Trust), T Mcnally(University of Leicester), Melitta A. McNarry, J McNeill(Newcastle upon Tyne Hospitals NHS Foundation Trust), Alison McQueen(University of Birmingham), H McShane(University of Birmingham), C Mears(Newcastle upon Tyne Hospitals NHS Foundation Trust), C Megson(University of Leicester), S Megson(University of Leicester), Puja Mehta(University of Leicester), James Meiring(Newcastle upon Tyne Hospitals NHS Foundation Trust), L Melling(University of Birmingham), Mark Mencias(Newcastle upon Tyne Hospitals NHS Foundation Trust), Dan Menzies(University of Leicester), Marta Merida Morillas(University of Birmingham), A. Michael(University of Leicester), Chris Miller(University of Birmingham), Lea Milligan(University of Leicester), C Mills, Gary Mills(University of Leicester), Nicholas L. Mills(Newcastle upon Tyne Hospitals NHS Foundation Trust), L Milner(University of Leicester), S Misra, James Mitchell(University of Leicester), A. Mohamed(Newcastle upon Tyne Hospitals NHS Foundation Trust), N Mohamed, Sarhan Mohammed(Newcastle upon Tyne Hospitals NHS Foundation Trust), Philip L. Molyneaux(Newcastle upon Tyne Hospitals NHS Foundation Trust), W Monteiro, S Moriera(University of Leicester), Anna Morley(University of Leicester), Leigh Morrison, Richard Morriss, A Morrow(University of Leicester), Alison Moss(University of Leicester), Paul Moss(University of Leicester), K Motohashi(University of Leicester), N Msimanga(King's College London), Elizabeta B. Mukaetova‐Ladinska(University of Leicester), U Munawar(King's College London), Jennifer Murira(Newcastle upon Tyne Hospitals NHS Foundation Trust), Uttam Nanda(Newcastle upon Tyne Hospitals NHS Foundation Trust), H Nassa, M Nasseri(University of Leicester), A Neal(University of Leicester), R. Needham(Newcastle upon Tyne Hospitals NHS Foundation Trust), P Neill(University of Leicester), Stefan Neubauer(Newcastle upon Tyne Hospitals NHS Foundation Trust), David E. Newby(University of Birmingham), Helen Newell(University of Leicester), Tom Newman, Julia Newman(University of Birmingham), A. Newton-Cox(University of Birmingham), Timothy R. Nicholson, D Nicoll(King's College London), A. Nikolaidis, Claire M. Nolan(University of Birmingham), Maria Noonan(University of Leicester), Chris Norman(University of Leicester), Petr Novotný(University of Leicester), J Nunag(King's College London), Lorenza Nwafor(University of Leicester), U Nwanguma(University of Birmingham), J Nyaboko(University of Leicester), Conor O’Brien(University of Birmingham), Kate O’Donnell(University of Leicester), David O’Regan(University of Leicester), L O'Brien(University of Leicester), N Odell(University of Birmingham), Graham S. Ogg(University of Birmingham), O Olaosebikan(NHS Lothian), C Oliver, Z Omar(University of Leicester), Peter Openshaw(University of Leicester), L. Orriss-Dib(University of Leicester), Lynn Osborne(Newcastle upon Tyne Hospitals NHS Foundation Trust), R Osbourne(University of Birmingham), Marlies Ostermann(University of Leicester), Christopher E. Overton(University of Leicester), J. Owen(University of Leicester), J Oxton(University of Leicester), Jamie Pack(Newcastle upon Tyne Hospitals NHS Foundation Trust), Edmund Pacpaco(Newcastle upon Tyne Hospitals NHS Foundation Trust), Stella‐Maria Paddick, S Painter(Newcastle upon Tyne Hospitals NHS Foundation Trust), Ashkan Pakzad(University of Leicester), S. Palmer(University of Leicester), Padmasayee Papineni(University of Leicester), Kitty Paques(Newcastle upon Tyne Hospitals NHS Foundation Trust), Kerry Paradowski(University Hospitals Birmingham NHS Foundation Trust), Manish Pareek(Newcastle upon Tyne Hospitals NHS Foundation Trust), Dhruv Parekh(University Hospitals Birmingham NHS Foundation Trust), Helen Parfrey(Newcastle upon Tyne Hospitals NHS Foundation Trust), Carmine M. Pariante(Newcastle upon Tyne Hospitals NHS Foundation Trust), Sean Parker(University of Leicester), Miles Parkes(Newcastle upon Tyne Hospitals NHS Foundation Trust), J. Parmar(University of Oxford), S Patale(Newcastle upon Tyne Hospitals NHS Foundation Trust), B. Patel(Newcastle upon Tyne Hospitals NHS Foundation Trust), Manish Patel(University of Birmingham), S. Patel(Newcastle upon Tyne Hospitals NHS Foundation Trust), D Pattenadk(Newcastle upon Tyne Hospitals NHS Foundation Trust), M Pavlides(University of Leicester), Sarah Payne(Imperial College London), Lyndsay Pearce(University of Birmingham), John E. Pearl(University of Leicester), D. Peckham(King's College London), Jessica Pendlebury(University of Birmingham), Yun Peng(University of Leicester), Catherine Pennington(University of Leicester), I Peralta(NHS Lothian), Emma Perkins(University of Birmingham), Zhane Peterkin(University of Leicester), Tim Peto(University of Leicester), Nayia Petousi(University of Leicester), Jennifer Petrie(University of Leicester), Paul Pfeffer(University of Leicester), J Phipps(University of Leicester), J Pimm(University of Leicester), Karen Piper Hanley(Newcastle upon Tyne Hospitals NHS Foundation Trust), Riinu Pius(Newcastle upon Tyne Hospitals NHS Foundation Trust), H Plant(University of Birmingham), Sven Plein(Newcastle upon Tyne Hospitals NHS Foundation Trust), Tatiana Plekhanova(Asthma UK), Megan Plowright(University of Birmingham), K. Poinasamy(University of Leicester), O Polgar(University of Leicester), Lonneke van de Poll(University of Leicester), Joanna C. Porter(Newcastle upon Tyne Hospitals NHS Foundation Trust), Joanna C. Porter(University of Leicester), S Portukhay, Neil Powell(University of Leicester), A Prabhu, John Pratt(University of Birmingham), Angeline Price(University of Birmingham), Christopher Price(University of Birmingham), Christopher Price(University of Leicester), D Price(University of Leicester), L Price, L Price(University of Leicester), A Prickett(Newcastle upon Tyne Hospitals NHS Foundation Trust), J. Propescu(Newcastle upon Tyne Hospitals NHS Foundation Trust), S. Prosper(Newcastle upon Tyne Hospitals NHS Foundation Trust), S. Pugmire(University of Leicester), Sheena Quaid(Imperial College London), J Quigley(Newcastle upon Tyne Hospitals NHS Foundation Trust), Jennifer K Quint(University of Leicester), H Qureshi(University of Leicester), Ibraheem Qureshi(University of Edinburgh), Kavita Radhakrishnan(Newcastle upon Tyne Hospitals NHS Foundation Trust), Najib M. Rahman(University of Oxford), Markus Ralser, Betty Raman(Newcastle upon Tyne Hospitals NHS Foundation Trust), A. Ramos(University of Leicester), H. Ramos(University of Oxford), J Rangeley(University of Leicester), B Rangelov(University of Leicester), L Ratcliffe, P Ravencroft(University of Leicester), A Reddington, Raghunath Reddy(Newcastle upon Tyne Hospitals NHS Foundation Trust), A. Vijaya Bhaskar Reddy(University of Birmingham), H Redfearn, Dawn Redwood(Newcastle upon Tyne Hospitals NHS Foundation Trust), Anna Reed(University of Birmingham), Megan Rees(University of Leicester), T Rees(Newcastle upon Tyne Hospitals NHS Foundation Trust), Karen Regan(University of Birmingham), Will Reynolds(University of Leicester), Cinthia Mucci Ribeiro(University of Leicester), A Richards(University of Leicester), E Richardson(University of Leicester), Matthew Richardson(University of Leicester), Pilar Rivera‐Ortega(University of Leicester), K. Roberts(University of Leicester), Elaine Robertson(University of Leicester), Emma C. Robinson(University of Leicester), Lisa A. Robinson(University of Birmingham), L Roche(University of Leicester), Chloe Roddis, J. Rodger(University of Leicester), Amelia Ross(University of Leicester), G Ross, J Rossdale, Anthony Rostron, Anna Rowe(University of Leicester), A. Rowland, J Rowland(University of Manchester), Matthew Rowland(University of Leicester), Sarah Rowland‐Jones(Newcastle upon Tyne Hospitals NHS Foundation Trust), Krishna Chandra Roy(University of Leicester), Maxim Roy(University of Leicester), Igor Rudan(University of Leicester), R Russell(University of Leicester), Emma Russell(University of Leicester), G Saalmink(University Hospitals Birmingham NHS Foundation Trust), R. Sabit(University of Birmingham), Elizabeth K. Sage(University of Leicester), T Samakomva(University of Birmingham), N Samani(University of Leicester), Claire Sampson(University of Leicester), Katie Samuel, R Samuel(University of Leicester), Amanda Sanderson(University of Birmingham), Elizabeth Sapey(University of Leicester), Dinesh Saralaya(University of Birmingham), J. Sargant(University of Birmingham), C Sarginson(University of Leicester), Thea Sass(University of Leicester), Naveed Sattar(University of Leicester), Karen Saunders(University of Leicester), Ruth Saunders(University of Leicester), Peter Saunders(Newcastle upon Tyne Hospitals NHS Foundation Trust), Laura Saunders(Newcastle upon Tyne Hospitals NHS Foundation Trust), Heather Savill, W Saxon(University of Leicester), Avan Aihie Sayer(Newcastle upon Tyne Hospitals NHS Foundation Trust), J Schronce, Wilhelm Schwaeble(University of Leicester), J. T. Scott(University of Leicester), K Scott, Nicholas M. Selby(University of Leicester), Malcolm G. Semple(University of Leeds), Marco Sereno(University of Leicester), T Sewell(University of Leicester), Abhijit Shah(University of Leicester), Kanan Shah(Newcastle upon Tyne Hospitals NHS Foundation Trust), Pallav L. Shah(Newcastle upon Tyne Hospitals NHS Foundation Trust), Manu Shankar‐Hari(University of Birmingham), Manish Sharma(Newcastle upon Tyne Hospitals NHS Foundation Trust), Claire C. Sharpe(Newcastle upon Tyne Hospitals NHS Foundation Trust), Michael Sharpe, S Shashaa(University of Leicester), Albert C. Shaw(University Hospitals Birmingham NHS Foundation Trust), Kaitlin Shaw, Victoria Shaw(Newcastle upon Tyne Hospitals NHS Foundation Trust), Aziz Sheikh(University of Leicester), Sarah Shelton(University of Leicester), L Shenton(University of Leicester), K Shevket(University of Leicester), A Shikotra(University of Leicester), Jay M. Short(Newcastle upon Tyne Hospitals NHS Foundation Trust), S Siddique(University of Leicester), Salman Siddiqui(University of Leicester), J Sidebottom(University of Leicester), Louise Sigfrid(University of Leicester), G Simons(University of Leicester), Jennifer Simpson(University of Leicester), Nicholas Simpson(University of Leicester), Amisha Singapuri(University of Leicester), Claire Singh(University of Leicester), Sally Singh(University of Leicester), Sally Singh(University of Leicester), D Sissons(University of Leicester), J Skeemer, Katie Slack(University of Birmingham), Anne Smith(Newcastle upon Tyne Hospitals NHS Foundation Trust), D Smith(University of Leicester), Susan M. Smith(University of Leicester), John A. Smith(Newcastle upon Tyne Hospitals NHS Foundation Trust), Lauren C. Smith, M Soares(University of Leicester), T S Solano(University of Birmingham), Reanne Solly(University of Birmingham), A R Solstice(University of Birmingham), T Soulsby(University of Birmingham), David Southern(Newcastle upon Tyne Hospitals NHS Foundation Trust), D. Sowter(University of Nottingham), Mark Spears(Imperial College London), Lisa Spencer(University of Leicester), F Speranza(Newcastle upon Tyne Hospitals NHS Foundation Trust), Louise Stadon(University of Leicester), Stefan Stanel(University of Leicester), N Steele(University of Birmingham), Michael Steiner(University of Leicester), David J. Stensel(University of Leicester), G Stephens(Newcastle upon Tyne Hospitals NHS Foundation Trust), L Stephenson(University of Leicester), M Stern(University of Leicester), Iain Stewart(Newcastle upon Tyne Hospitals NHS Foundation Trust), R Stimpson(University of Leicester), Skye Stockdale(Newcastle upon Tyne Hospitals NHS Foundation Trust), James Stockley(University of Leicester), William Thornley Stoker(Newcastle upon Tyne Hospitals NHS Foundation Trust), Richard Stone, W Storrar(University of Leicester), A. Storrie(University of Leicester), Kim Storton(Newcastle upon Tyne Hospitals NHS Foundation Trust), Jeffrey S. A. Stringer(University of Leicester), Sophia Strong-Sheldrake(University of Birmingham), Natalie Stroud(University of Leicester), Christian P Subbe(NHS Lothian), Cathie Sudlow(University of Birmingham), Z Suleiman(University of Birmingham), Charlotte Summers(University of Birmingham), Christina Summersgill, D Sutherland(University of Leicester), Dominic L. Sykes(University of Leicester), Robert Sykes(University of Leeds), Nick P. Talbot(University of Leicester), A.L. Tan(University of Leeds), L Tarusan, Vera Tavoukjian(University of Birmingham), Alex H. Taylor(University of Leicester), C Taylor(University of Leicester), J Taylor(Newcastle upon Tyne Hospitals NHS Foundation Trust), A Te(Nottingham University Hospitals NHS Trust), H Tedd(University of Leicester), C J Tee(Newcastle upon Tyne Hospitals NHS Foundation Trust), J Teixeira(Newcastle upon Tyne Hospitals NHS Foundation Trust), Helen Tench(Newcastle upon Tyne Hospitals NHS Foundation Trust), S. Terry(Imperial College London), S. Thackray-Nocera(University of Oxford), Favas Thaivalappil(University of Birmingham), B Thamu(University of Birmingham), David Thickett(King's College London), C Thomas(Newcastle upon Tyne Hospitals NHS Foundation Trust), David Thomas, S Thomas(University of Birmingham), Andrew Thomas(University of Birmingham), T Thomas-Woods(University of Leicester), T Thompson(University of Birmingham), A. A. Roger Thompson(Newcastle upon Tyne Hospitals NHS Foundation Trust), T Thornton(University of Leicester), Mathew Thorpe(University of Leicester), Ryan S. Thwaites(University of Leicester), J Tilley, N Tinker(Newcastle upon Tyne Hospitals NHS Foundation Trust), Gerlynn Tiongson(University of Leicester), Martin D. Tobin(University of Birmingham), James Tomlinson(Newcastle upon Tyne Hospitals NHS Foundation Trust), Catherine Tong(University of Leicester), Mark Toshner, Rhian M. Touyz(University of Leicester), K A Tripp, Elizabeth M. Tunnicliffe(University of Leicester), Alison E. Turnbull(Newcastle upon Tyne Hospitals NHS Foundation Trust), Emma L. Turner(University Hospitals Birmingham NHS Foundation Trust), Steve Turner(University of Leicester), Victoria Turner(Newcastle upon Tyne Hospitals NHS Foundation Trust), K. Turner(University of Leicester), Sharon Turney(Newcastle upon Tyne Hospitals NHS Foundation Trust), Lance Turtle(University of Leicester), H. Turton(University of Leicester), J Ugoji(University of Leicester), R Ugwuoke(University of Leicester), Rachel Upthegrove(Newcastle upon Tyne Hospitals NHS Foundation Trust), Jonathan Valabhji(University of Leicester), M. Ventura(University of Birmingham), Joanne Vere(University of Oxford), Carinna Vickers(University of Leicester), B Vinson(University of Leicester), Erin A. Wade(University of Leicester), Phillip Wade(University of Birmingham), Louise V. Wain(University of Leicester), Thomas W. Wainwright(Newcastle upon Tyne Hospitals NHS Foundation Trust), L O Wajero(Newcastle upon Tyne Hospitals NHS Foundation Trust), S Walder(Newcastle upon Tyne Hospitals NHS Foundation Trust), S Walker(University of Leicester), S Walker(University of Birmingham), Emma Wall(Newcastle upon Tyne Hospitals NHS Foundation Trust), T Wallis(University of Birmingham), Sharon Walmsley(Newcastle upon Tyne Hospitals NHS Foundation Trust), Jessica A. Walsh(University of Leicester), S Walsh, L Warburton(University of Leicester), Tom Ward(Newcastle upon Tyne Hospitals NHS Foundation Trust), K Warwick(Newcastle upon Tyne Hospitals NHS Foundation Trust), Helen Wassall(University of Leicester), Sharon Waterson(University of Leicester), Eleanor Watson(University of Leicester), Lea C. Watson(University of Leicester), Judith Watson(University of Birmingham), J. Weir McCall(University of Birmingham), Carly Welch(University of Oxford), H Welch(Newcastle upon Tyne Hospitals NHS Foundation Trust), B Welsh(Newcastle upon Tyne Hospitals NHS Foundation Trust), Simon Wessely(Newcastle upon Tyne Hospitals NHS Foundation Trust), S West(Newcastle upon Tyne Hospitals NHS Foundation Trust), H Weston(Newcastle upon Tyne Hospitals NHS Foundation Trust), Helen Wheeler(University Hospitals Birmingham NHS Foundation Trust), Simon R. White(King's College London), Victor Whitehead(Newcastle upon Tyne Hospitals NHS Foundation Trust), Julie Whitney(King's College London), Spence Whittaker(University Hospitals Birmingham NHS Foundation Trust), B. Whittam, V Whitworth(University of Leicester), Andrew Wight(Newcastle upon Tyne Hospitals NHS Foundation Trust), Jim M. Wild(University of Birmingham), M Wilkins(University of Oxford), Dean Wilkinson(University of Leicester), Bryan Williams(University of Leicester), Nefyn Williams(University of Leicester), Nefyn Williams(University of Leicester), Justin H. G. Williams(Newcastle upon Tyne Hospitals NHS Foundation Trust), S A Williams-Howard(University of Leicester), Michelle Willicombe(University of Leicester), Guillermo B. Willis, J Willoughby(University of Birmingham), A Wilson(University of Leicester), David M. Wilson(University of Leicester), Iseult Wilson(Newcastle upon Tyne Hospitals NHS Foundation Trust), Nicola Window(University of Leicester), Miles D. Witham(Newcastle upon Tyne Hospitals NHS Foundation Trust), R Wolf-Roberts(Imperial College London), C Wood(University of Leicester), Felix Woodhead, Jeffrey A. Woods(University of Leicester), Dan Wootton(University of Leicester), Joanne Wormleighton(University of Birmingham), J Worsley(University of Birmingham), David C. Wraith(University of Birmingham), C Wrey Brown(University of Leicester), Clinton B. Wright(Newcastle upon Tyne Hospitals NHS Foundation Trust), L Wright(University of Leicester), S. Wright(University of Leicester), J Wyles(Newcastle upon Tyne Hospitals NHS Foundation Trust), Inez Wynter(University of Leicester), Mengxin Xu(Newcastle upon Tyne Hospitals NHS Foundation Trust), N Yasmin(University of Birmingham), S Yasmin, Thomas Yates(University of Oxford), Kay Por Yip(Newcastle upon Tyne Hospitals NHS Foundation Trust), Bob Young, Scott Young, Alison L. Young, Ahmed Yousuf(University of Leicester), A. Zawia(University of Oxford), Lisa Zeidan(University of Oxford), Boya Zhao(University of Birmingham), Bang Zheng, O Zongo
Cited by 22Open Access
Abstract
Background: The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods: This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group-robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)-at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Findings: Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Interpretation: Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained pre-frail or frail. This suggests comprehensive assessment and interventions targeting pre-frailty and frailty beyond the initial illness are required. Funding: UK Research and Innovation and National Institute for Health Research.
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