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Study Description

Adverse effects of the coronavirus disease 2019 (COVID19) pandemic on US society, health, and economy are widespread. The Collaborative Cohort of Cohorts for COVID-19 Research (C4R) aims to advance our knowledge on the impact of the COVID-19 pandemic in the United States. C4R is a diverse national prospective study comprising 14 long-standing prospective cohort studies and over 49,000 participants with extensive pre-COVID-19 phenotype data. C4R links pre-pandemic data on clinical and subclinical diseases and their risk factors, including behavior, cognition, biomarkers, and social determinants of health, to information on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and acute and post-acute COVID-related illness. Ascertainment of COVID-19 infection occurs via standardized questionnaires, adjudication of COVID-related hospitalizations and deaths, and SARS-CoV-2 serosurvey via dried blood spot cards. C4R is investigating the following research questions: 1) how pre-existing health conditions affect risk of severe or prolonged COVID-19 related illness; 2) how SARS-CoV-2 infection and COVID-19 illness affect long-term health; and 3) how the pandemic has affected health-related behaviors and non-COVID health outcomes. This resource will allow evaluation of risk and resilience factors for COVID-19 severity and long-term health effects.

Cohort Description

In 1948, the researchers recruited 5,209 men and women between the ages of 30 and 62 from the town of Framingham, Massachusetts, and began the first round of extensive physical examinations and lifestyle interviews that they would later analyze for common patterns related to CVD development. Since 1948, the subjects have returned to the study every two years for an examination consisting of a detailed medical history, physical examination, and laboratory tests, and in 1971, the study enrolled a second-generation cohort -- 5,124 of the original participants' adult children and their spouses -- to participate in similar examinations. The second examination of the Offspring cohort occurred eight years after the first examination, and subsequent examinations have occurred approximately every four years thereafter. In 1994, the need to establish a new study reflecting a more diverse community of Framingham was recognized, and the first Omni cohort of the Framingham Heart Study, consisting of 506 participants, was enrolled. In April 2002 4095 third generation of participants, the grandchildren of the original cohort, were added. In 2003, 103 spouses of the offspring Cohort (NOS), and a second group of 410 Omni participants were enrolled. Through 2019, the original cohort has completed a total of 32 exams, the Offspring cohort 9 exams, the OMNI1 cohort 4 exams, and GEN3, NOS and OMNI2 cohorts each have completed 3 exams. The FHS is a joint project of the National Heart, Lung and Blood Institute and Boston University.

Data Being Submitted

  • Wave 1 questionnaire data includes 3967 variables for up to 3112 FHS participants in C4R.
  • Wave 2 questionnaire data includes 448 variables for up to 2337 FHS participants in C4R.
  • Dried Blood Spot/Serosurvey data includes 7 variables for up to 2189 FHS participants in C4R.
  • Derived data includes 43 variables for up to 3151 FHS participants in C4R.
  • Phenotype data includes 113 variables for up to 3151 FHS participants in C4R.

Authorized Access
Publicly Available Data
  Link to other NCBI resources related to this study
Study Inclusion/Exclusion Criteria

Please see phs000007.

Study History

Please see phs000007.

Selected Publications
Diseases/Traits Related to Study (MeSH terms)
Authorized Data Access Requests
See articles in PMC citing this study accession
Study Attribution
  • Principal Investigator
    • Elizabeth C. Oelsner, MD, MPH. Columbia University Irving Medical Center, New York, NY, USA.
  • Co-Principal Investigator
    • R. Graham Barr, MD, DrPH. Columbia University Irving Medical Center, New York, NY, USA.
  • Co-Investigator
    • Pallavi Balte, MBBS, MPH, PhD. Columbia University Irving Medical Center, New York, NY, USA.
  • Cohort Principal Investigator
    • Vasan Ramachandran, MD. Boston University, Boston, MA, USA.
  • Cohort Co-Investigator
    • Nancy L. Heard-Costa, MPH, PhD. Boston University, Boston, MA, USA.