Collaborative Cohort of Cohorts for COVID-19 Research (C4R): REasons for Geographic and Racial Differences in Stroke (REGARDS)

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.

• Study Weblinks:
  • 1) C4R: www.c4r-nih.org
  • 2) REGARDS: https://www.uab.edu/soph/regardsstudy/
• Study Design:
  • Prospective Longitudinal Cohort
• Study Type:
  • Longitudinal Cohort
• Total number of consented subjects: 8707
• Subject Sample Telemetry Report (SSTR)

• BioProject
• PubMed
• MeSH

REGARDS Inclusion Criteria:

• Aged 45 years or older
• African American or white

REGARDS Exclusion Criteria:

• Race other than African American or white
• Active treatment for cancer
• Medical conditions that would prevent long-term participation
• Cognitive impairment, judged by the telephone interviewer
• Residence in or inclusion on a waiting list for a nursing home
• Inability to communicate in English

REGARDS C4R Inclusion Criteria:

• REGARDS participants who:
  1. Are active
  2. Have completed the 2nd in-home exam

The (REGARDS) cohort is one of the nation's largest, most comprehensive population-based cohorts, and it uses innovative home- and telephone-based data collection. REGARDS centrally recruited and initially examined 30,239 Black and White men and women aged ≥45 years in 2003-7 to understand why Southerners and Black Americans have a higher incidence of stroke and related diseases that affect brain health. REGARDS has conducted annual follow-up with participants since enrollment and pursues medical records for relevant events. In 2020, REGARDS worked with C4R to understand the impact of SARS-CoV2 on the cohort.

• Primary Phenotype: COVID-19
• SARS-CoV-2
• COVID-19 Serological Testing
• COVID-19 Testing
• COVID-19 Vaccines

• 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 Investigators
  • Virginia Howard. University of Alabama, Birmingham, AL, USA.
  • Suzanne Judd. University of Alabama, Birmingham, AL, USA.
  • Mary Cushman. University of Vermont, Burlington, VT, USA.
• Cohort Co-Investigator
  • Emily Levitan. University of Alabama, Birmingham, AL, USA.
• Data Manager
  • Ya Yuan. University of Alabama, Birmingham, AL, USA.