Data collection

C4R is currently collecting information on SARS-CoV-2 infection, COVID-19 illness, and other pandemic-related exposures, across over 50,000 US adults.

An overview of C4R data from before, during, and after the pandemic is provided here, and the C4R Study Design Paper posted on medRxiv provides additional information: https://medrxiv.org/cgi/content/short/2021.03.19.21253986v1

The official C4R questionnaire is also available on the NIH Public Health Emergency and Disaster Research Response (DR2) portal: https://tools.niehs.nih.gov/dr2/index.cfm/resource/24223.

What measures are available for C4R participants from before the COVID-19 pandemic?

The depth and breadth of pre-COVID phenotyping in C4R far exceeds information typically available for adults receiving usual healthcare.  For example, most individuals without known heart disease do not receive a cardiac MRI to examine the structure of their hearts -- but, in the C4R cohorts, we have many healthy individuals who have previously undergone tests like this. As a result, C4R will be able to address certain questions that cannot be studied via electronic medical records or case registries of COVID patients.

Organ Systems

Individuals from the participating cohort studies will be invited to complete a questionnaire regarding their experiences during the COVID-19 pandemic. Specifically, they will be asked if they tested positive for SARS-CoV-2, what symptoms they experienced and for how long, and whether they required hospitalization. The first wave of C4R questionnaires is currently being administered, and a follow-up survey, which will include questions about stress, fatigue, depression, and the potential impact of the pandemic on other health conditions, will be accomplished in 2021. 

Medical records will be reviewed to assess what treatments they may have received for COVID-19 and whether they experienced complications such as heart attack, pneumonia, stroke, or blood clots.

Participants will provide a small blood sample, obtained through a finger stick at home, that will be analyzed for antibodies to SARS-CoV-2. This will allow the researchers to detect asymptomatic cases of COVID-19, which will offer a more accurate estimate of the number of individuals who were infected. The blood samples also may allow researchers to understand how the status of the immune system before the pandemic may be related to antibody responses and the severity of COVID-19 illness. 

Data Collection Timeline

Over the next few years, additional exams are planned for C4R participants. Many of these exams will include heart, lung, and brain imaging, as well as biomarker panels and genomic studies.