Isfahan COVID cohort study: Rationale, methodology, and initial results

Nizal Sarrafzadegan; Noushin Mohammadifard; Shaghayegh Haghjooy Javanmard; Fahimeh Haghighatdoost; Fatemeh Nouri; Mahshid Ahmadian; Maryam Nasirian; Maedeh Sayyah; Jamshid Najafian; Mohammadreza Shafiei; Hassan Alikhasi; Sahel Javanbakht; Farzaneh Nilforoushzadeh; Fahimeh Bagheri; Shahla Shahidi; Mostafa Rezaei; Kamal Heidari; Behrouz Keleidari; Tahereh Changiz

doi:10.4103/jrms.jrms_552_21

Isfahan COVID cohort study: Rationale, methodology, and initial results

J Res Med Sci. 2022 Aug 30:27:65. doi: 10.4103/jrms.jrms_552_21. eCollection 2022.

Authors

Nizal Sarrafzadegan^{1

2}, Noushin Mohammadifard¹, Shaghayegh Haghjooy Javanmard³, Fahimeh Haghighatdoost⁴, Fatemeh Nouri⁵, Mahshid Ahmadian⁶, Maryam Nasirian⁷, Maedeh Sayyah⁸, Jamshid Najafian⁴, Mohammadreza Shafiei¹, Hassan Alikhasi⁹, Sahel Javanbakht¹⁰, Farzaneh Nilforoushzadeh¹, Fahimeh Bagheri¹, Shahla Shahidi¹, Mostafa Rezaei¹¹, Kamal Heidari¹², Behrouz Keleidari¹³, Tahereh Changiz¹⁴

Affiliations

¹ Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
² Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
³ Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
⁴ Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
⁶ Department of Noncommunicable Control, Vice Chancellery of Health Isfahan University of Medical Sciences, Isfahan, Iran.
⁷ Department of Epidemiology and Biostatistics, Health School, Isfahan University of Medical Sciences, Isfahan, Iran.
⁸ Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
⁹ Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
¹⁰ Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
¹¹ Executive Assistant, Vice Chancellery of Health Isfahan University of Medical Sciences, Isfahan, Iran.
¹² Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
¹³ Department of Surgery, Isfahan Minimally Invasive Surgery and Obesity Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
¹⁴ Department of Medical Education, Medical Educational Research Center, Isfahan University of Medical Science, Isfahan, Iran.

Abstract

Background: The Isfahan COVID Cohort (ICC) study was designed to investigate the short- and long-term consequences of patients with COVID-19 in Iran. This report presents the rationale, methodology, and initial results of ICC.

Materials and methods: ICC is a 5-year multicentric prospective cohort study that is ongoing on two groups including 5000 patients hospitalized with moderate or severe and 800 nonhospitalized patients with mild or asymptomatic COVID-19 in Isfahan. The ICC endpoints are morbidity, mortality, incident cases, or worsening of underlying noncommunicable diseases (NCDs) and their risk factors. In the current analysis, we examined the persistent symptoms and incident NCDs or risk factors in 819 previously hospitalized patients who completed 1-year follow-up.

Results: The two most common symptoms were joint pain/myalgia (19.7%) and dry cough/dyspnea (18.7%). Around 60% of patients had at least one symptom which was more common among women than men and in middle aged than younger or older patients. Female (odds ratio [OR] =1.88, 95% confidence interval [CI]: 1.39-2.55) and highly-educated patients (OR = 2.18, 95% CI: 1.56-3.04) had higher risk of having any symptom in 1-year follow-up. New cases of hypertension followed by diabetes then coronary heart disease (CHD) were the most common incident NCDs.

Conclusion: During 1-year follow-up after hospital discharge, about 60% of patients experienced persistent symptoms. Incident hypertension, diabetes, and CHD were the most common events seen. Close monitoring and extensive health services with integrative approaches are needed to improve the health status of these patients.

Keywords: COVID-19; morbidity; mortality; outcome; prospective cohort study; symptom.