Chapter 1 26 Part 1: Epidemiological and long-term clinical features of COVID-19 in Amsterdam, the Netherlands In Part 1 of this thesis, we aim to describe the epidemiology and symptomatology of SARS-CoV-2 infection and highlight the clinical features of long COVID. In Chapters 2 and Chapter 3, differences in hospitalisation rates by city district and migration background during the first and second waves of COVID-19 in Amsterdam, the Netherlands, are evaluated. In Chapter 4, the evolution of symptoms among participants of the RECoVERED cohort study during both the acute phase and up to 12 months after illness onset are presented. Subsequently, in Chapter 5, the proportion of RECoVERED participants with severe fatigue is assessed. Part 2: In-depth characterisation of long COVID: Trajectories and possible pathogenesis In Part 2 of this thesis, we conduct an in-depth characterisation of long COVID, with an emphasis on describing trajectories of different clinical features over time, exploring possible biological mechanisms of disease, and examining the potential for COVID-19 vaccination as a treatment for long COVID. In Chapter 6, two-year trajectories of long COVID symptoms in the RECoVERED cohort, and their associated with illness perception, are presented. We then describe the association between long COVID and inflammatory markers at 3 and 6 months after illness onset in Chapter 7, and explore possible early biomarkers for ongoing long COVID at 6 months. Finally, we investigate the possible therapeutic effect of SARS-CoV-2 vaccination on long COVID symptoms in Chapter 8, supplementing this with a comparative analysis of antibody dynamics between study participants with and without long COVID. In Chapter 9, I place the findings listed above into context and highlight future research priorities stemming from the themes discussed.
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