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549300YU8CMO9HF53113 QuidelOrtho Corp 219798105 25359.00000000 NS USD 1028307.45000000 0.034568719556 Long EC CORP US N 1 N N N Encompass Health Corp 549300FVRPM9DRQZRG64 Encompass Health Corp 29261A100 50361.00000000 NS USD 4199100.18000000 0.141161591809 Long EC CORP US N 1 N N N Aurinia Pharmaceuticals Inc 5299008YP2BW4570ML28 Aurinia Pharmaceuticals Inc 05156V102 67248.00000000 NS USD 342292.32000000 0.011506876874 Long EC CORP CA N 1 N N N Soleno Therapeutics Inc 5493003LCY77N7FXK844 Soleno Therapeutics Inc 834203309 7676.00000000 NS USD 342810.16000000 0.011524285156 Long EC CORP US N 1 N N N Savara Inc 5493002JO0WM3YMJXG33 Savara Inc 805111101 37556.00000000 NS USD 172006.48000000 0.005782359905 Long EC CORP US N 1 N N N Phibro Animal Health Corp 549300U24SP4AF2JUX52 Phibro Animal Health Corp 71742Q106 10290.00000000 NS USD 171843.00000000 0.005776864180 Long EC CORP US N 1 N N N Alkermes PLC N/A Alkermes PLC 000000000 79272.00000000 NS USD 1945334.88000000 0.065396526991 Long 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1 N N N SIGA Technologies Inc N/A SIGA Technologies Inc 826917106 22645.00000000 NS USD 198823.10000000 0.006683857036 Long EC CORP US N 1 N N N Quest Diagnostics Inc 8MCWUBXQ0WE04KMXBX50 Quest Diagnostics Inc 74834L100 56617.00000000 NS USD 7823337.06000000 0.262997943680 Long EC CORP US N 1 N N N STERIS PLC N/A STERIS PLC 000000000 49807.00000000 NS USD 10188519.92000000 0.342508544315 Long EC CORP IE N 1 N N N Clover Health Investments Corp 5493000HLYOYQU6LK133 Clover Health Investments Corp 18914F103 185672.00000000 NS USD 116973.36000000 0.003932305729 Long EC CORP US N 1 N N N Scholar Rock Holding Corp 549300Z1FLPGL4OWJ459 Scholar Rock Holding Corp 80706P103 20021.00000000 NS USD 293708.07000000 0.009873615039 Long EC CORP US N 1 N N N West Pharmaceutical Services Inc 5493007NKRGM1RJQ1P16 West Pharmaceutical Services Inc 955306105 37299.00000000 NS USD 13333646.52000000 0.448238595580 Long EC CORP US N 1 N N N Varex Imaging Corp 549300CWYWPVCT8E9W67 Varex Imaging Corp 92214X106 20268.00000000 NS USD 329355.00000000 0.011071961629 Long EC CORP US N 1 N N N PTC Therapeutics Inc 549300UJLWOIWFDGB318 PTC Therapeutics Inc 69366J200 33947.00000000 NS USD 1091396.05000000 0.036689575649 Long EC CORP US N 1 N N N CryoPort Inc 9845004D8538BT8JF626 CryoPort Inc 229050307 24483.00000000 NS USD 396379.77000000 0.013325140362 Long EC CORP US N 1 N N N Waters Corp 5T547R1474YC9HOD8Q74 Waters Corp 941848103 29797.00000000 NS USD 9208464.88000000 0.309561931094 Long EC CORP US N 1 N N N Eli Lilly & Co FRDRIPF3EKNDJ2CQJL29 Eli Lilly & Co 532457108 406609.00000000 NS USD 317602289.90000000 10.67686953934 Long EC CORP US N 1 N N N Novavax Inc 529900J4GJHPEPQ23205 Novavax Inc 670002401 53919.00000000 NS USD 233469.27000000 0.007848560972 Long EC CORP US N 1 N N N Henry Schein Inc VGO3WGL8H45T73F4RR92 Henry Schein Inc 806407102 65330.00000000 NS USD 4526062.40000000 0.152153115101 Long EC CORP US N 1 N N N Evolus Inc 549300VYQRYBQOT8V419 Evolus Inc 30052C107 23673.00000000 NS USD 278631.21000000 0.009366774652 Long EC CORP US N 1 N N N SpringWorks Therapeutics Inc N/A SpringWorks Therapeutics Inc 85205L107 23452.00000000 NS USD 1094973.88000000 0.036809851935 Long EC CORP US N 1 N N N 4D Molecular Therapeutics Inc N/A 4D Molecular Therapeutics Inc 35104E100 13435.00000000 NS USD 321499.55000000 0.010807884141 Long EC CORP US N 1 N N N MaxCyte Inc 54930053YHXULRFCU991 MaxCyte Inc 57777K106 43363.00000000 NS USD 157407.69000000 0.005291590848 Long EC CORP US N 1 N N N Royalty Pharma PLC 549300FGFN7VOK8BZR03 Royalty Pharma PLC 000000000 191492.00000000 NS USD 5304328.40000000 0.178316164969 Long EC CORP GB N 1 N N N Mirum Pharmaceuticals Inc 254900YZKR40F7F27K81 Mirum Pharmaceuticals Inc 604749101 15058.00000000 NS USD 378106.38000000 0.012710841891 Long EC CORP US N 1 N N N Longboard Pharmaceuticals Inc N/A Longboard Pharmaceuticals Inc 54300N103 10797.00000000 NS USD 229976.10000000 0.007731130709 Long EC CORP US N 1 N N N Roivant Sciences Ltd 549300DL466NY5J6U724 Roivant Sciences Ltd 000000000 141904.00000000 NS USD 1546753.60000000 0.051997378236 Long EC CORP BM N 1 N N N Catalent Inc N/A Catalent Inc 148806102 91110.00000000 NS USD 5088493.50000000 0.171060420466 Long EC CORP US N 1 N N N Castle Biosciences Inc N/A Castle Biosciences Inc 14843C105 12452.00000000 NS USD 262612.68000000 0.008828278047 Long EC CORP US N 1 N N N Corcept Therapeutics Inc 529900EO9LUTFMZ7FF90 Corcept Therapeutics Inc 218352102 44701.00000000 NS USD 1042427.32000000 0.035043388709 Long EC CORP US N 1 N N N IDEXX Laboratories Inc OGMTXK0LUU1HKV2P0J84 IDEXX Laboratories Inc 45168D104 41864.00000000 NS USD 20628904.64000000 0.693484054067 Long EC CORP US N 1 N N N Hologic Inc 549300DYP6F5ZJL0LB74 Hologic Inc 436440101 121061.00000000 NS USD 9172791.97000000 0.308362711131 Long EC CORP US N 1 N N N Baxter International Inc J5OIVXX3P24RJRW5CK77 Baxter International Inc 071813109 255133.00000000 NS USD 10299719.21000000 0.346246742527 Long EC CORP US N 1 N N N Bristol-Myers Squibb Co HLYYNH7UQUORYSJQCN42 Bristol-Myers Squibb Co 110122108 1025308.00000000 NS USD 45052033.52000000 1.514518942941 Long EC CORP US N 1 N N N ARS Pharmaceuticals Inc N/A ARS Pharmaceuticals Inc 82835W108 18537.00000000 NS USD 161271.90000000 0.005421494401 Long EC CORP US N 1 N N N Xencor Inc 549300V5IF65437JKG30 Xencor Inc 98401F105 27928.00000000 NS USD 584812.32000000 0.019659697187 Long EC CORP US N 1 N N N State Street Global Advisors 549300PNASLVKQG64331 State Street Institutional Treasury Plus Money Market Fund 857492862 3434000.00000000 NS USD 3434000.00000000 0.115441138694 Long STIV RF US N 1 N N N Maravai LifeSciences Holdings Inc N/A Maravai LifeSciences Holdings Inc 56600D107 57033.00000000 NS USD 467670.60000000 0.015721731682 Long EC CORP US N 1 N N N Allogene Therapeutics Inc N/A Allogene Therapeutics Inc 019770106 54542.00000000 NS USD 150535.92000000 0.005060581834 Long EC CORP US N 1 N N N Gilead Sciences Inc 549300WTZWR07K8MNV44 Gilead Sciences Inc 375558103 627873.00000000 NS USD 40937319.60000000 1.376194172898 Long EC CORP US N 1 N N N Janux Therapeutics Inc N/A Janux Therapeutics Inc 47103J105 8152.00000000 NS USD 464664.00000000 0.015620658494 Long EC CORP US N 1 N N N MannKind Corp 213800GFBCNY1ZFST722 MannKind Corp 56400P706 137124.00000000 NS USD 563579.64000000 0.018945915954 Long EC CORP US N 1 N N N Zentalis Pharmaceuticals Inc N/A Zentalis Pharmaceuticals Inc 98943L107 24428.00000000 NS USD 270173.68000000 0.009082456978 Long EC CORP US N 1 N N N 2024-05-20 FIDELITY COVINGTON TRUST Laura Del Prato Laura Del Prato President and Treasurer XXXX NPORT-EX 2 NPORT_PBR4_15777279_0424.htm FOR VALIDATION PURPOSES ONLY - [852658.TX6]
Quarterly Holdings Report
for
Fidelity® MSCI Health Care Index ETF
April 30, 2024
T05-NPRT3-0624
1.9584810.110

Schedule of Investments April 30, 2024 (Unaudited)
Showing Percentage of Net Assets
Common Stocks – 99.8%
    Shares Value
BIOTECHNOLOGY – 18.0% 
Biotechnology – 18.0%
4D Molecular Therapeutics, Inc. (a) 13,435 $ 321,500
89bio, Inc. (a) 38,745 329,720
AbbVie, Inc. 889,663 144,694,790
ACADIA Pharmaceuticals, Inc. (a) 53,575 895,238
ADMA Biologics, Inc. (a) 109,562 714,344
Agios Pharmaceuticals, Inc. (a) 28,348 921,310
Akero Therapeutics, Inc. (a) 26,716 531,381
Akouos, Inc. (a)(b) 11,863 9,846
Alector, Inc. (a) 35,588 180,787
Alkermes PLC (a) 79,272 1,945,335
Allogene Therapeutics, Inc. (a) 54,542 150,536
Alnylam Pharmaceuticals, Inc. (a) 63,304 9,112,611
Alpine Immune Sciences, Inc. (a) 16,241 1,049,006
Altimmune, Inc. (a) 27,103 177,525
ALX Oncology Holdings, Inc. (a) 11,292 192,190
Amgen, Inc. 269,685 73,877,509
Amicus Therapeutics, Inc. (a) 111,275 1,111,637
AnaptysBio, Inc. (a) 5,367 130,633
Anavex Life Sciences Corp. (a) 41,670 152,096
Apellis Pharmaceuticals, Inc. (a) 35,855 1,584,432
Apogee Therapeutics, Inc. (a) 10,532 529,760
Arcellx, Inc. (a) 14,361 718,337
Arcturus Therapeutics Holdings, Inc. (a) 12,005 306,968
Arcus Biosciences, Inc. (a) 23,940 364,606
Ardelyx, Inc. (a) 117,085 749,344
Arrowhead Pharmaceuticals, Inc. (a) 61,761 1,397,034
ARS Pharmaceuticals, Inc. (a) 18,537 161,272
Aurinia Pharmaceuticals, Inc. (a) 67,248 342,292
Avid Bioservices, Inc. (a) 30,945 236,110
Avidity Biosciences, Inc. (a) 35,958 867,667
Beam Therapeutics, Inc. (a) 34,935 741,321
BioCryst Pharmaceuticals, Inc. (a) 93,730 387,105
Biogen, Inc. (a) 73,015 15,685,082
Biohaven Ltd. (a) 36,436 1,413,717
BioMarin Pharmaceutical, Inc. (a) 94,901 7,664,205
Biomea Fusion, Inc. (a) 11,268 121,018
Blueprint Medicines Corp. (a) 28,937 2,643,106
Bridgebio Pharma, Inc. (a) 52,662 1,349,200
Cabaletta Bio, Inc. (a) 15,122 160,974
Cargo Therapeutics, Inc. (a) 7,277 138,991
Catalyst Pharmaceuticals, Inc. (a) 53,376 803,309
Celldex Therapeutics, Inc. (a) 29,257 1,094,797
Cerevel Therapeutics Holdings, Inc. (a) 36,577 1,562,204
Chinook Therapeutics, Inc. (a) 24,218 0
Cogent Biosciences, Inc. (a) 31,403 204,120
Crinetics Pharmaceuticals, Inc. (a) 32,209 1,411,398
CRISPR Therapeutics AG (a) 38,087 2,018,230

    Shares Value
Cullinan Therapeutics, Inc. (a) 17,915 $ 483,884
Cytokinetics, Inc. (a) 44,525 2,730,273
Day One Biopharmaceuticals, Inc. (a) 23,937 409,323
Deciphera Pharmaceuticals, Inc. (a) 17,635 445,636
Denali Therapeutics, Inc. (a) 55,079 850,420
Disc Medicine, Inc. (a) 6,080 169,267
Dynavax Technologies Corp. (a) 61,963 704,519
Dyne Therapeutics, Inc. (a) 21,792 551,556
Editas Medicine, Inc. (a) 36,783 191,639
Entrada Therapeutics, Inc. (a) 5,386 63,824
Exact Sciences Corp. (a) 91,301 5,418,714
Exelixis, Inc. (a) 141,154 3,311,473
Fusion Pharmaceuticals, Inc. (a) 21,923 469,810
Geron Corp. (a) 211,680 831,902
Gilead Sciences, Inc. 627,873 40,937,320
Halozyme Therapeutics, Inc. (a) 66,821 2,545,880
HilleVax, Inc. (a) 9,688 127,882
Ideaya Biosciences, Inc. (a) 28,464 1,157,062
ImmunityBio, Inc. (a) 68,632 548,370
Immunome, Inc. (a) 18,259 256,722
Immunovant, Inc. (a) 25,310 694,506
Incyte Corp. (a) 95,851 4,989,045
Inhibrx, Inc. (a) 10,731 365,283
Insmed, Inc. (a) 68,963 1,704,765
Intellia Therapeutics, Inc. (a) 43,096 922,254
Ionis Pharmaceuticals, Inc. (a) 65,252 2,692,298
Iovance Biotherapeutics, Inc. (a) 96,826 1,140,610
Ironwood Pharmaceuticals, Inc. (a) 71,660 555,365
iTeos Therapeutics, Inc. (a) 11,392 122,350
Janux Therapeutics, Inc. (a) 8,152 464,664
Keros Therapeutics, Inc. (a) 12,996 732,844
Kiniksa Pharmaceuticals Ltd. Class A (a) 14,863 278,235
Krystal Biotech, Inc. (a) 9,333 1,429,069
Kura Oncology, Inc. (a) 25,616 502,586
Kymera Therapeutics, Inc. (a) 20,359 684,470
Lyell Immunopharma, Inc. (a) 61,358 133,147
MacroGenics, Inc. (a) 23,466 346,827
Madrigal Pharmaceuticals, Inc. (a) 5,962 1,216,367
MannKind Corp. (a) 137,124 563,580
Merus NV (a) 19,153 860,161
MiMedx Group, Inc. (a) 57,201 352,358
Mirum Pharmaceuticals, Inc. (a) 15,058 378,106
Moderna, Inc. (a) 163,317 18,015,498
MoonLake Immunotherapeutics (a) 8,946 365,981
Morphic Holding, Inc. (a) 15,268 416,358
Myriad Genetics, Inc. (a) 44,641 873,624
Natera, Inc. (a) 57,569 5,347,009
Neurocrine Biosciences, Inc. (a) 49,558 6,816,207
Novavax, Inc. (a) 53,919 233,469
Nuvalent, Inc. Class A (a) 13,106 902,741
 
2 Quarterly Report 

Schedule of Investments (Unaudited)continued
Common Stocks – continued
    Shares Value
BIOTECHNOLOGY – continued
Biotechnology – continued
Olema Pharmaceuticals, Inc. (a) 18,662 $ 189,793
Protagonist Therapeutics, Inc. (a) 23,665 594,228
Prothena Corp. PLC (a) 19,894 404,644
PTC Therapeutics, Inc. (a) 33,947 1,091,396
Radius Health, Inc. (a)(b) 20,244 0
Rapt Therapeutics, Inc. (a) 11,615 89,436
Recursion Pharmaceuticals, Inc. Class A (a) 78,806 616,263
Regeneron Pharmaceuticals, Inc. (a) 53,979 48,076,936
REGENXBIO, Inc. (a) 20,821 319,602
Relay Therapeutics, Inc. (a) 40,784 265,912
Replimune Group, Inc. (a) 17,164 108,991
REVOLUTION Medicines, Inc. (a) 50,912 1,897,999
Rhythm Pharmaceuticals, Inc. (a) 23,925 951,258
Rocket Pharmaceuticals, Inc. (a) 31,843 685,261
Roivant Sciences Ltd. (a) 141,904 1,546,754
Sage Therapeutics, Inc. (a) 27,543 383,949
Sana Biotechnology, Inc. (a) 49,298 443,682
Sarepta Therapeutics, Inc. (a) 42,469 5,379,124
Savara, Inc. (a) 37,556 172,006
Scholar Rock Holding Corp. (a) 20,021 293,708
Soleno Therapeutics, Inc. (a) 7,676 342,810
SpringWorks Therapeutics, Inc. (a) 23,452 1,094,974
Spyre Therapeutics, Inc. (a) 9,996 330,168
Summit Therapeutics, Inc. (a) 68,603 269,610
Syndax Pharmaceuticals, Inc. (a) 38,490 813,294
Tango Therapeutics, Inc. (a) 19,786 152,352
TG Therapeutics, Inc. (a) 72,599 991,702
Tourmaline Bio, Inc. 8,184 129,553
Travere Therapeutics, Inc. (a) 37,549 207,646
Twist Bioscience Corp. (a) 29,217 912,447
Ultragenyx Pharmaceutical, Inc. (a) 37,288 1,586,232
United Therapeutics Corp. (a) 23,601 5,530,422
Vaxcyte, Inc. (a) 45,370 2,747,154
Vera Therapeutics, Inc. (a) 15,609 616,712
Veracyte, Inc. (a) 36,822 720,607
Vericel Corp. (a) 22,961 1,053,221
Vertex Pharmaceuticals, Inc. (a) 129,850 51,006,378
Verve Therapeutics, Inc. (a) 25,363 152,432
Viking Therapeutics, Inc. (a) 42,871 3,411,674
Vir Biotechnology, Inc. (a) 47,068 398,195
Viridian Therapeutics, Inc. (a) 20,959 277,916
Xencor, Inc. (a) 27,928 584,812
Xenon Pharmaceuticals, Inc. (a) 31,444 1,278,199
Zentalis Pharmaceuticals, Inc. (a) 24,428 270,174
Zymeworks, Inc. (a) 21,801 187,053
TOTAL BIOTECHNOLOGY 536,036,525
HEALTH CARE EQUIPMENT & SUPPLIES – 20.1% 
Health Care Equipment – 18.8%
Abbott Laboratories 874,793 92,701,814

    Shares Value
Alphatec Holdings, Inc. (a) 47,129 $ 594,768
Artivion, Inc. (a) 19,115 375,036
AtriCure, Inc. (a) 23,928 577,143
Axonics, Inc. (a) 25,543 1,700,398
Baxter International, Inc. 255,133 10,299,719
Becton Dickinson & Co. 145,897 34,227,436
Boston Scientific Corp. (a) 738,211 53,055,225
CONMED Corp. 15,424 1,048,524
DexCom, Inc. (a) 194,696 24,802,323
Edwards Lifesciences Corp. (a) 305,620 25,876,845
Enovis Corp. (a) 24,559 1,356,394
Envista Holdings Corp. (a) 86,451 1,701,356
GE HealthCare Technologies, Inc. 206,461 15,740,587
Glaukos Corp. (a) 23,205 2,227,680
Globus Medical, Inc. Class A (a) 58,173 2,896,434
Hologic, Inc. (a) 121,061 9,172,792
IDEXX Laboratories, Inc. (a) 41,864 20,628,905
Inari Medical, Inc. (a) 25,866 965,836
Inspire Medical Systems, Inc. (a) 14,919 3,605,326
Insulet Corp. (a) 35,082 6,031,999
Integer Holdings Corp. (a) 16,828 1,878,510
Integra LifeSciences Holdings Corp. (a) 33,523 977,866
Intuitive Surgical, Inc. (a) 177,405 65,749,841
iRadimed Corp. 4,435 180,105
iRhythm Technologies, Inc. (a) 15,428 1,690,600
LeMaitre Vascular, Inc. 9,934 643,723
LivaNova PLC (a) 27,330 1,523,647
Masimo Corp. (a) 22,570 3,033,634
Medtronic PLC 669,997 53,760,559
Nevro Corp. (a) 17,566 185,848
Novocure Ltd. (a) 51,982 636,260
Omnicell, Inc. (a) 22,831 612,099
Orthofix Medical, Inc. (a) 16,670 216,710
Paragon 28, Inc. (a) 18,765 173,013
Penumbra, Inc. (a) 18,477 3,630,176
PROCEPT BioRobotics Corp. (a) 22,998 1,218,434
Pulmonx Corp. (a) 17,591 133,868
QuidelOrtho Corp. (a) 25,359 1,028,307
ResMed, Inc. 74,141 15,865,433
Shockwave Medical, Inc. (a) 18,617 6,147,147
SI-BONE, Inc. (a) 19,131 272,808
Steris PLC 49,807 10,188,520
Stryker Corp. 172,312 57,982,988
Tandem Diabetes Care, Inc. (a) 32,406 1,188,976
Teleflex, Inc. 23,747 4,957,186
TransMedics Group, Inc. (a) 16,537 1,556,628
Treace Medical Concepts, Inc. (a) 22,788 236,312
Varex Imaging Corp. (a) 20,268 329,355
Zimmer Biomet Holdings, Inc. 105,336 12,669,814
      558,254,907
 
 Quarterly Report 3

Common Stocks – continued
    Shares Value
HEALTH CARE EQUIPMENT & SUPPLIES – continued
Health Care Supplies – 1.3%
Align Technology, Inc. (a) 36,679 $ 10,357,416
Atrion Corp. 677 286,567
Avanos Medical, Inc. (a) 23,279 420,884
Cooper Cos., Inc. 99,857 8,893,264
DENTSPLY SIRONA, Inc. 106,930 3,208,969
Embecta Corp. 28,401 287,702
Establishment Labs Holdings, Inc. (a) 9,577 478,946
Haemonetics Corp. (a) 25,519 2,346,472
ICU Medical, Inc. (a) 10,292 1,007,793
Lantheus Holdings, Inc. (a) 34,379 2,287,579
Merit Medical Systems, Inc. (a) 28,976 2,147,122
Neogen Corp. (a) 103,710 1,278,744
OraSure Technologies, Inc. (a) 38,741 204,940
OrthoPediatrics Corp. (a) 8,563 253,722
RxSight, Inc. (a) 13,568 707,300
Solventum Corp. (a) 73,854 4,801,249
STAAR Surgical Co. (a) 19,411 892,130
UFP Technologies, Inc. (a) 3,695 760,948
      40,621,747
TOTAL HEALTH CARE EQUIPMENT & SUPPLIES 598,876,654
HEALTH CARE PROVIDERS & SERVICES – 20.7% 
Health Care Distributors – 2.6%
AdaptHealth Corp. (a) 36,868 363,150
Cardinal Health, Inc. 124,222 12,799,835
Cencora, Inc. 85,981 20,553,758
Henry Schein, Inc. (a) 65,330 4,526,062
McKesson Corp. 67,063 36,026,914
Owens & Minor, Inc. (a) 34,712 858,775
Patterson Cos., Inc. 42,052 1,071,064
PetIQ, Inc. (a) 13,899 226,832
      76,426,390
Health Care Facilities – 1.9%
Acadia Healthcare Co., Inc. (a) 46,389 3,430,003
Brookdale Senior Living, Inc. (a) 89,556 608,085
Community Health Systems, Inc. (a) 69,037 227,822
Encompass Health Corp. 50,361 4,199,100
Ensign Group, Inc. 28,558 3,380,125
HCA Healthcare, Inc. 101,164 31,342,630
National HealthCare Corp. 7,069 642,360
Select Medical Holdings Corp. 54,435 1,544,321
Surgery Partners, Inc. (a) 34,996 873,150
Tenet Healthcare Corp. (a) 46,209 5,188,809
U.S. Physical Therapy, Inc. 7,577 769,141
Universal Health Services, Inc. Class B 30,776 5,245,154
      57,450,700

    Shares Value
Health Care Services – 4.7%
23andMe Holding Co. Class A (a) 133,881 $ 67,235
Accolade, Inc. (a) 35,726 272,589
Addus HomeCare Corp. (a) 8,291 797,180
Agiliti, Inc. (a) 19,724 200,199
agilon health, Inc. (a) 153,066 841,863
Amedisys, Inc. (a) 16,469 1,515,971
AMN Healthcare Services, Inc. (a) 19,027 1,141,239
Astrana Health, Inc. (a) 23,521 873,805
Castle Biosciences, Inc. (a) 12,452 262,613
Chemed Corp. 7,222 4,102,096
Cigna Group 147,439 52,641,621
CorVel Corp. (a) 4,734 1,130,716
Cross Country Healthcare, Inc. (a) 17,643 310,517
CVS Health Corp. 648,455 43,906,888
DaVita, Inc. (a) 27,692 3,849,465
DocGo, Inc. (a) 46,112 155,859
Enhabit, Inc. (a) 21,312 215,038
Fulgent Genetics, Inc. (a) 9,325 189,764
Guardant Health, Inc. (a) 58,146 1,046,628
Hims & Hers Health, Inc. (a) 70,944 888,928
Laboratory Corp. of America Holdings 42,809 8,620,448
LifeStance Health Group, Inc. (a) 47,740 295,033
ModivCare, Inc. (a) 5,495 128,968
National Research Corp. 7,644 261,807
NeoGenomics, Inc. (a) 64,401 896,462
Opko Health, Inc. (a) 208,893 254,849
Option Care Health, Inc. (a) 89,347 2,670,582
Pediatrix Medical Group, Inc. (a) 40,822 362,091
Pennant Group, Inc. (a) 14,852 310,555
Premier, Inc. Class A 59,901 1,250,733
Privia Health Group, Inc. (a) 47,048 865,683
Quest Diagnostics, Inc. 56,617 7,823,337
R1 RCM, Inc. (a) 84,047 1,032,938
RadNet, Inc. (a) 29,119 1,412,272
      140,595,972
Managed Health Care – 11.5%
Alignment Healthcare, Inc. (a) 50,649 260,842
Centene Corp. (a) 269,175 19,665,926
Clover Health Investments Corp. (a) 185,672 116,973
Elevance Health, Inc. 118,408 62,588,101
HealthEquity, Inc. (a) 43,235 3,411,674
Humana, Inc. 62,030 18,738,643
Molina Healthcare, Inc. (a) 29,374 10,048,845
Progyny, Inc. (a) 43,747 1,402,529
UnitedHealth Group, Inc. 466,076 225,440,961
      341,674,494
TOTAL HEALTH CARE PROVIDERS & SERVICES 616,147,556
4 Quarterly Report 

Schedule of Investments (Unaudited)continued
Common Stocks – continued
    Shares Value
HEALTH CARE TECHNOLOGY – 0.8% 
Health Care Technology – 0.8%
Certara, Inc. (a) 56,012 $ 958,365
Definitive Healthcare Corp. (a) 25,544 177,275
Doximity, Inc. Class A (a) 55,165 1,339,958
Evolent Health, Inc. Class A (a) 52,183 1,447,556
GoodRx Holdings, Inc. Class A (a) 40,110 284,781
Health Catalyst, Inc. (a) 27,463 170,820
HealthStream, Inc. 12,299 316,945
Multiplan Corp. (a) 131,093 85,184
Phreesia, Inc. (a) 26,622 552,140
Schrodinger, Inc. (a) 31,762 774,358
Sharecare, Inc. (a) 169,547 121,379
Simulations Plus, Inc. 7,774 352,551
Teladoc Health, Inc. (a) 83,321 1,062,343
Veeva Systems, Inc. Class A (a) 77,064 15,301,828
TOTAL HEALTH CARE TECHNOLOGY 22,945,483
LIFE SCIENCES TOOLS & SERVICES – 11.3% 
Life Sciences Tools & Services – 11.3%
10X Genomics, Inc. Class A (a) 44,630 1,306,766
Adaptive Biotechnologies Corp. (a) 49,560 129,847
Agilent Technologies, Inc. 147,640 20,232,586
Avantor, Inc. (a) 341,041 8,263,423
Azenta, Inc. (a) 25,296 1,327,028
BioLife Solutions, Inc. (a) 19,035 333,874
Bio-Rad Laboratories, Inc. Class A (a) 10,918 2,945,130
Bio-Techne Corp. 79,627 5,033,223
Bruker Corp. 45,390 3,540,874
Charles River Laboratories International, Inc. (a) 25,763 5,899,727
CryoPort, Inc. (a) 24,483 396,380
Cytek Biosciences, Inc. (a) 53,459 321,289
Danaher Corp. 353,713 87,232,700
Fortrea Holdings, Inc. (a) 44,025 1,610,875
Illumina, Inc. (a) 80,092 9,855,321
IQVIA Holdings, Inc. (a) 91,963 21,314,264
Maravai LifeSciences Holdings, Inc. Class A (a) 57,033 467,671
MaxCyte, Inc. (a) 43,363 157,408
Medpace Holdings, Inc. (a) 12,382 4,808,550
Mesa Laboratories, Inc. 2,604 276,232
Mettler-Toledo International, Inc. (a) 10,933 13,444,310
OmniAb, Inc. (a) 45,347 201,341
OmniAb, Inc. (a)(b) 3,335 13,907
OmniAb, Inc. (a)(b) 3,335 13,006
Pacific Biosciences of California, Inc. (a) 120,052 198,086
Quanterix Corp. (a) 18,076 291,385
Repligen Corp. (a) 26,810 4,402,202
Revvity, Inc. 62,057 6,358,981

    Shares Value
Sotera Health Co. (a) 49,747 $ 557,166
Standard BioTools, Inc. (a) 104,493 259,143
Thermo Fisher Scientific, Inc. 194,695 110,726,940
Waters Corp. (a) 29,797 9,208,465
West Pharmaceutical Services, Inc. 37,299 13,333,646
TOTAL LIFE SCIENCES TOOLS & SERVICES 334,461,746
PHARMACEUTICALS – 28.9% 
Pharmaceuticals – 28.9%
Amneal Pharmaceuticals, Inc. (a) 61,834 374,096
Amphastar Pharmaceuticals, Inc. (a) 19,540 806,025
Amylyx Pharmaceuticals, Inc. (a) 22,121 40,039
AN2 Therapeutics, Inc. (a) 10,392 24,941
ANI Pharmaceuticals, Inc. (a) 8,247 544,302
Arvinas, Inc. (a) 29,165 926,572
Axsome Therapeutics, Inc. (a) 15,362 1,133,101
Bristol-Myers Squibb Co. 1,025,308 45,052,034
Cassava Sciences, Inc. (a) 19,618 434,539
Catalent, Inc. (a) 91,110 5,088,494
Collegium Pharmaceutical, Inc. (a) 16,303 602,070
Corcept Therapeutics, Inc. (a) 44,701 1,042,427
Edgewise Therapeutics, Inc. (a) 17,100 306,774
Elanco Animal Health, Inc. (a) 249,113 3,278,327
Eli Lilly & Co. 406,609 317,602,290
Enliven Therapeutics, Inc. (a) 7,290 126,773
Evolus, Inc. (a) 23,673 278,631
EyePoint Pharmaceuticals, Inc. (a) 22,157 389,963
Harmony Biosciences Holdings, Inc. (a) 16,539 511,221
Harrow, Inc. (a) 15,358 156,498
Innoviva, Inc. (a) 28,146 425,286
Intra-Cellular Therapies, Inc. (a) 43,567 3,128,546
Jazz Pharmaceuticals PLC (a) 30,027 3,325,490
Johnson & Johnson 1,213,031 175,392,152
Ligand Pharmaceuticals, Inc. (a) 8,253 576,802
Liquidia Corp. (a) 22,959 295,023
Longboard Pharmaceuticals, Inc. (a) 10,797 229,976
Merck & Co., Inc. 1,276,894 165,000,243
Organon & Co. 127,936 2,380,889
Pacira BioSciences, Inc. (a) 23,067 605,509
Perrigo Co. PLC 68,455 2,235,740
Pfizer, Inc. 2,845,208 72,894,229
Phathom Pharmaceuticals, Inc. (a) 13,540 122,266
Phibro Animal Health Corp. Class A 10,290 171,843
Pliant Therapeutics, Inc. (a) 22,469 265,584
Prestige Consumer Healthcare, Inc. (a) 25,097 1,800,961
Revance Therapeutics, Inc. (a) 51,212 184,875
Royalty Pharma PLC Class A 191,492 5,304,328
Scilex Holding Co. (a) 34,921 26,815
SIGA Technologies, Inc. 22,645 198,823
Supernus Pharmaceuticals, Inc. (a) 26,842 807,944
 
 Quarterly Report 5

Common Stocks – continued
    Shares Value
PHARMACEUTICALS – continued
Pharmaceuticals – continued
Tarsus Pharmaceuticals, Inc. (a) 11,215 $ 352,488
Terns Pharmaceuticals, Inc. (a) 15,322 77,376
Theravance Biopharma, Inc. (a) 17,629 148,789
Tilray Brands, Inc. (a) 400,237 988,585
Viatris, Inc. 605,203 7,002,199
WaVe Life Sciences Ltd. (a) 41,720 205,680
Zoetis, Inc. 231,339 36,838,422
TOTAL PHARMACEUTICALS 859,705,980
TOTAL COMMON STOCKS
(Cost $2,387,171,720)
2,968,173,944
Money Market Fund – 0.1%
       
State Street Institutional Treasury Plus Money Market Fund 5.24% (c)
(Cost $3,434,000)
3,434,000 3,434,000
TOTAL INVESTMENT IN SECURITIES – 99.9%
(Cost $2,390,605,720)
2,971,607,944
NET OTHER ASSETS (LIABILITIES) (d) – 0.1% 3,065,070
NET ASSETS – 100.0% $2,974,673,014
    
Legend  
(a) Non-income producing.
(b) Level 3 security.
(c) The rate quoted is the annualized seven-day yield of the fund at period end.
(d) Includes $217,500 of cash collateral to cover margin requirements for futures contracts.
Futures Contracts
  Number of
contracts
Expiration
Date
Notional
Amount
Value Unrealized
Appreciation/
(Depreciation)
Purchased          
Equity Index Contracts          
CME E-mini Health Care Select Sector Index Contracts (United States) 37 June 2024 5,275,090 (118,332) (118,332)
CME E-mini Russell 2000 Index Contracts (United States) 5 June 2024 496,400 (20,321) (20,321)
Total Equity Index Contracts         $(138,653)
The notional amount of futures purchased as a percentage of Net Assets is 0.2%
Investment Valuation
Investments are valued as of 4:00 p.m. Eastern time on the last calendar day of the period. Securities transactions are accounted for as of trade date. The Board of Trustees (the Board) has delegated the day to day responsibility for the valuation of the Fund’s investments to the Fair Value Committee (the Committee) established by the Fund's investment adviser. In accordance with valuation policies and procedures approved by the Board, the Fund attempts to obtain prices from one or more third party pricing vendors or brokers to value its investments. When current market prices, quotations or currency exchange rates are not readily available or reliable, investments will be fair valued in good faith by the Committee, in accordance with procedures adopted by the Board. Factors used in determining fair value
6 Quarterly Report 

Schedule of Investments (Unaudited)continued
vary by investment type and may include market or investment specific event. The frequency with which these procedures are used cannot be predicted and they may be utilized to a significant extent. The Committee oversees the Fund’s valuation policies and procedures and reports to the Board on the Committee’s activities and fair value determinations. The Board monitors the appropriateness of the procedures used in valuing the Fund’s investments and ratifies the fair value determinations of the Committee.
The inputs to valuation techniques used to value investments are categorized into a disclosure hierarchy consisting of three levels as shown below:
Level 1 – unadjusted quoted prices in active markets for identical investments
Level 2 – other significant observable inputs (including quoted prices for similar investments, interest rates, prepayment speeds, etc.)
Level 3 – unobservable inputs (including the Fund's own assumptions based on the best information available)
Valuation techniques used to value investments by major category are as follows:
Equity securities, including restricted securities, for which market quotations are readily available, are valued at the last reported sale price or official closing price as reported by a third party pricing service on the primary market or exchange on which they are traded and are categorized as Level 1 in the hierarchy. In the event there were no sales during the day or closing prices are not available, securities are valued at the last quoted bid price or may be valued using the last available price and are generally categorized as Level 2 in the hierarchy. For any foreign equity securities, when market or security specific events arise, comparisons to the valuation of American Depositary Receipts (ADRs), futures contracts, Exchange-Traded Funds (ETFs) and certain indexes as well as quoted prices for similar securities may be used and would be categorized as Level 2 in the hierarchy. For equity securities, including restricted securities, where observable inputs are limited, assumptions about market activity and risk are used and these securities may be categorized as Level 3 in the hierarchy.
Futures contracts are valued at the settlement price established each day by the board of trade or exchange on which they are traded and are categorized as Level 1 in the hierarchy. Investments in any open-end mutual funds are valued at their closing net asset value (NAV) each business day and are categorized as Level 1 in the hierarchy. If an unaffiliated open-end mutual fund’s NAV is unavailable, shares of that fund may be valued by another method that the Board believes reflects fair value in accordance with the Board’s fair value pricing policies and is categorized as Level 2 in the hierarchy.
Changes in valuation techniques may result in transfers in or out of an assigned level within the disclosure hierarchy.
Derivative Instruments
Risk Exposures and the Use of Derivative Instruments: The Fund's investment objectives allow the Fund to enter into various types of derivative contracts. Derivatives are investments whose value is primarily derived from underlying assets, indices or reference rates and may be transacted on an exchange or over-the-counter (OTC). Derivatives may involve a future commitment to buy or sell a specified asset based on specified terms, to exchange future cash flows at periodic intervals based on a notional principal amount, or for one party to make one or more payments upon the occurrence of specified events in exchange for periodic payments from the other party.
The Fund used derivatives to increase returns, to gain exposure to certain types of assets and/or to manage exposure to certain risks as defined below. The success of any strategy involving derivatives depends on analysis of numerous economic factors, and if the strategies for investment do not work as intended, the Fund may not achieve its objectives.
The Fund's use of derivatives increased or decreased its exposure to the following risk(s):
Equity Risk - Equity risk relates to the fluctuations in the value of financial instruments as a result of changes in market prices (other than those arising from interest rate risk or foreign exchange risk), whether caused by factors specific to an individual investment, its issuer, or all factors affecting all instruments traded in a market or market segment.
Investing in derivatives may involve greater risks than investing in the underlying assets directly and, to varying degrees, may involve risk of loss in excess of any initial investment and collateral received. In addition, there may be the risk that the change in value of the derivative contract does not correspond to the change in value of the underlying instrument.
Futures Contracts: A futures contract is an agreement between two parties to buy or sell a specified underlying instrument for a specified price at a specified future date.
The Fund used futures contracts to manage its exposure to the stock market.
Open futures contracts at period end are presented in the Schedule of Investments under the caption "Futures Contracts". The underlying face amount at value reflects each contract's exposure to the underlying instrument or index at period end. Any securities and/or cash deposited to meet initial margin requirements are identified in the Schedule of Investments.
For additional information on the Fund’s significant accounting policies, please refer to the Fund’s most recent semiannual or annual shareholder report.
 Quarterly Report 7

The fund’s schedule of investments as of the date on the cover of this report has not been audited. This report is provided for the general information of the fund’s shareholders. For more information regarding the fund and its holdings, please see the fund’s most recent prospectus and annual report.
Third party trademarks and service marks are the property of their respective owners. All other trademarks and service marks are the property of FMR LLC or an affiliate.     
8 Quarterly Report