BackgroundRecovery trajectories from COVID-19 call for longitudinal investigation. We aimed to characterise the kinetics and status of clinical, cardiopulmonary and mental health recovery up to 1-year following COVID-19.MethodsClinical evaluation, lung function testing (LFT), chest computed tomography (CT) and transthoracic echocardiography (TTE) were conducted at 2-, 3-, 6- and 12 months after disease onset. Submaximal exercise capacity, mental health status and quality of life (QoL) were assessed at 12 months. Recovery kinetics and patterns were investigated by mixed-effect logistic modeling, correlation and clustering analyses. Risk of persistent symptoms and cardiopulmonary abnormalities at the 1-year follow-up were modeled by logistic regression.FindingsOut of 145 CovILD study participants, 108 (74.5%) completed the 1-year follow-up (median age: 56.5 years, 59.3% male; 24% ICU patients). Comorbidities were present in 75% (n=81). Key outcome measures plateaued after 180 days. At 12 months, persistent symptoms were found in 65%, 33% suffered from LFT impairment, 51% showed CT abnormalities, and 63% had low-grade diastolic dysfunction. Main risk factors for cardiopulmonary impairment included pro-inflammatory and immunological biomarkers at early visits. In addition, we deciphered three recovery clusters separating almost complete recovery from patients with post-acute inflammatory profile and an enrichment in cardiopulmonary residuals from a female-dominated post-COVID syndrome with reduced mental health status.ConclusionOne year after COVID-19, the burden of persistent symptoms, impaired lung function, radiological abnormalities remains high in our study population. Yet, three recovery trajectories are emerging, ranging from almost complete recovery to post-COVID syndrome with impaired mental health.