text: Multiorgan impairment in low risk individuals with post COVID 19 syndrome a prospective community based study To assess medium term organ impairment in symptomatic individuals following recovery from acute SARS CoV 2 infection Baseline findings from a prospective observational cohort study Community based individuals from two UK centres between 1 April and 14 September 2020 Individuals 18 years with persistent symptoms following recovery from acute SARS CoV 2 infection and age matched healthy controls Assessment of symptoms by standardised questionnaires EQ 5D 5L Dyspnoea 12 and organ specific metrics by biochemical assessment and quantitative MRI Severe post COVID 19 syndrome defined as ongoing respiratory symptoms and or moderate functional impairment in activities of daily living single organ and multiorgan impairment heart lungs kidneys liver pancreas spleen by consensus definitions at baseline investigation 201 individuals mean age 45 range 21 71 years 71 female 88 white 32 healthcare workers completed the baseline assessment median of 141 days following SARS CoV 2 infection IQR 110 162 The study population was at low risk of COVID 19 mortality obesity 20 hypertension 7 type 2 diabetes 2 heart disease 5 with only 19 hospitalised with COVID 19 42 of individuals had 10 or more symptoms and 60 had severe post COVID 19 syndrome Fatigue 98 muscle aches 87 breathlessness 88 and headaches 83 were most frequently reported Mild organ impairment was present in the heart 26 lungs 11 kidneys 4 liver 28 pancreas 40 and spleen 4 with single organ and multiorgan impairment in 70 and 29 respectively Hospitalisation was associated with older age p 0 001 non white ethnicity p 0 016 increased liver volume p 0 0001 pancreatic inflammation p 0 01 and fat accumulation in the liver p 0 05 and pancreas p 0 01 Severe post COVID 19 syndrome was associated with radiological evidence of cardiac damage myocarditis p 0 05 In individuals at low risk of COVID 19 mortality with ongoing symptoms 70 have impairment in one or more organs 4 months after initial COVID 19 symptoms with implications for healthcare and public health which have assumed low risk in young people with no comorbidities NCT04369807 Pre results 