The Nottingham recovery from COVID-19 research platform (NoRCoRP): Functional, clinical and patient-reported outcomes in adults referred to a post-COVID respiratory service
Malik Hamrouni, Ayushman Gupta, Sophie Middleton, Sabrina Prosper, Theresa Harvey-Dunstan, Joanne Porte, Tricia M. McKeever, Ian P. Hall, Charlotte E. Bolton
Abstract
Aims
To characterise symptoms, function and patient-reported outcome measures (PROMs), and identify associated factors in adults with persisting respiratory symptoms post-COVID.
Introduction
Although many individuals recover from acute COVID-19, a notable proportion experience persistent symptoms [1]. A meta-analysis including over 700 000 participants, with an average follow-up time of 4 months, found that almost half reported at least one unresolved symptom [2]. Such symptoms are heterogeneous and include fatigue, weakness, breathlessness, impaired sleep quality and cognitive difficulties [2,3].
Materials and method
Study design and participants
This was a cross-sectional single-centre study based at Nottingham University Hospitals (NUH) NHS Trust. Adults (≥ 18 years) referred from primary care to a post-COVID respiratory clinic were eligible; only those not hospitalised during their acute COVID-19 illness were included in this analysis. Referrals were made for persistent respiratory symptoms and/or new imaging changes after COVID-19 and were triaged by a clinician within NUH respiratory services.
Results
Demographics
Of the 249 people who attended the clinic, 39 were ineligible (hospitalised during their initial COVID infection and/or did not have at least one respiratory symptom), leaving a final analytical sample of 210 participants. A participant flow chart can be found in S1 Fig. Participants had a mean (standard deviation = SD) age of 49.4 (12.9) years, and 142 (68%) were female.
Discussion
This study provides a detailed profile of non-hospitalised adults with persistent respiratory symptoms after COVID-19 infection. The majority of patients experienced clinically significant breathlessness and dysregulated breathing, which is not surprising given that respiratory symptoms were required for referral to the clinic and therefore for study inclusion.
Acknowledgments
We thank the following for their assistance in the study’s conduct, clinical aspect of the visits, oversight and/or management: The NIHR Nottingham Respiratory research Delivery Team, Glenn Hearson (Database manager), Georgia Smith and the NUH Trust lung physiology team; NUH Trust respiratory and radiology clinical services and respiratory managers, Alex Jenkins (former research fellow, University of Nottingham) and Catherine Kelly (East Midlands Research Delivery Network). Thanks to Prof Trudie Chalder, King’s College London for use of the Chalder Fatigue Score.
Citation: Hamrouni M, Gupta A, Middleton S, Prosper S, Harvey-Dunstan T, Porte J, et al. (2026) The Nottingham recovery from COVID-19 research platform (NoRCoRP): Functional, clinical and patient-reported outcomes in adults referred to a post-COVID respiratory service. PLoS One 21(3): e0344210. https://doi.org/10.1371/journal.pone.0344210
Editor: Bharat Bhushan Sharma, SMS Medical College and Hospital, INDIA
Received: October 6, 2025; Accepted: February 17, 2026; Published: March 5, 2026
Copyright: © 2026 Hamrouni et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data are not publicly available due to containing sensitive patient information. Data may be made available upon request to researchers who meet the criteria for access, after discussion with the research team. To request access to data, please contact Mrs R Braybrooke (Biomedical Research Centre Manager, Rebecca.Braybrooke@nottingham.ac.uk).
Funding: CEB was the recipient PI and received funding from NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals Trust, and charitable donation via University of Nottingham Alumni. The views expressed in the publication are those of the authors and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: CEB reports grants from UKRI, NIHR and Nottingham Hospitals Charity for post-COVID research. IPH reports grants from NIHR, the Wellcome Trust and UKRI, and is the Vice-Chair of the Board of Trustees at Asthma + Lung UK. He has undertaken advisory board work with GSK (unrelated to the submitted work). All other authors declare no competing interests.
