A one-year hospital-based prospective COVID-19 open-cohort in the Eastern Mediterranean region: The Khorshid COVID Cohort (KCC) study

PLoS One. 2020 Nov 5;15(11):e0241537. doi: 10.1371/journal.pone.0241537. eCollection 2020.

Abstract

The COVID-19 is rapidly scattering worldwide, and the number of cases in the Eastern Mediterranean Region is rising. Thus, there is a need for immediate targeted actions. We designed a longitudinal study in a hot outbreak zone to analyze the serial findings between infected patients for detecting temporal changes from February 2020. In a hospital-based open-cohort study, patients are followed from admission until one year from their discharge (the 1st, 4th, 12th weeks, and the first year). The patient recruitment phase finished at the end of August 2020, and the follow-up continues by the end of August 2021. The measurements included demographic, socio-economics, symptoms, health service diagnosis and treatment, contact history, and psychological variables. The signs improvement, death, length of stay in hospital were considered primary, and impaired pulmonary function and psychotic disorders were considered main secondary outcomes. Moreover, clinical symptoms and respiratory functions are being determined in such follow-ups. Among the first 600 COVID-19 cases, 490 patients with complete information (39% female; the average age of 57±15 years) were analyzed. Seven percent of these patients died. The three main leading causes of admission were: fever (77%), dry cough (73%), and fatigue (69%). The most prevalent comorbidities between COVID-19 patients were hypertension (35%), diabetes (28%), and ischemic heart disease (14%). The percentage of primary composite endpoints (PCEP), defined as death, the use of mechanical ventilation, or admission to an intensive care unit was 18%. The Cox Proportional-Hazards Model for PCEP indicated the following significant risk factors: Oxygen saturation < 80% (HR = 6.3; [CI 95%: 2.5,15.5]), lymphopenia (HR = 3.5; [CI 95%: 2.2,5.5]), Oxygen saturation 80%-90% (HR = 2.5; [CI 95%: 1.1,5.8]), and thrombocytopenia (HR = 1.6; [CI 95%: 1.1,2.5]). This long-term prospective Cohort may support healthcare professionals in the management of resources following this pandemic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus
  • COVID-19
  • Comorbidity
  • Coronavirus Infections / epidemiology*
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Iran / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pandemics
  • Patient Discharge
  • Pneumonia, Viral / epidemiology*
  • Prospective Studies
  • Respiration, Artificial / statistics & numerical data
  • SARS-CoV-2

Grants and funding

The research leading to these results has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 712949 (TECNIOspring PLUS), and from the Agency for Business Competitiveness of the Government of Catalonia (TECSPR18-1-0017), the Spanish Ministry of Economy and Competitiveness – Spain (DPI2017-83989-R), and Isfahan University of Medical Sciences (IR.MUI.MED.REC.1399.029), and University of Isfahan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Prof. Marjan Mansourian received a salary from TECNIOspring PLUS.