The Role of Health-Related Factors in the Prevalence and Severity of COVID-19 - A Retrospective Cohort Study Based on Sabzevar Persian Cohort Data

Q: What was the main objective of the retrospective cohort study?

To investigate the association between pre-pandemic health-related factors and both the prevalence and severity of COVID-19 using Sabzevar PERSIAN cohort data.

Q: What factors were associated with higher COVID-19 severity?

Severity was higher among people aged ≥ 60, those with higher BMI, lower education, and comorbidities such as thyroid and ischemic heart disease, as well as certain biochemical markers including WBC, FBS, TG, and cholesterol (p < 0.05).

Sep 30, 2026

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Identifying health-related risk factors for COVID-19 can strengthen future prevention efforts. This retrospective cohort study examined whether pre-pandemic health characteristics predicted COVID-19 prevalence and clinical severity using Sabzevar data from the PERSIAN cohort. Health baseline variables were linked with SARS-CoV-2 PCR results and outcomes recorded in the health information system. Results showed 10% positivity and significant associations with diabetes, lower education, older age, higher BMI, comorbidities, and select biochemical markers.

LanguageEnglish

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Abstract

Background and Aims

Methods

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Introduction

Health Science Reports ORIGINAL RESEARCH The Role of Health‐Related Factors in the Prevalence and Severity ofCOVID‐19: A Retrospective Cohort Study Based on Sabzevar Persian Cohort Data Reza Ataee1 | Rohollah Borghabani2 | Shamim Shahrestani1 | Ezzat Samadipour3 | Marjan Vejdani4 | Fereshteh Ghorat2 1Faculty of Medicine, Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran | 2Non‐Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran | 3Sabzevar University of Medical Sciences, Sabzevar, Iran | 4Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran Correspondence: Marjan Vejdani ([marjanvejdani1986@gmail.com](marjanvejdani1986@gmail.com)) | Fereshteh Ghorat ([drghorat@gmail.com](drghorat@gmail.com)) Received: 6 April 2025 | Revised: 12 December 2025 | Accepted: 20 December 2025 Funding: Sabzevar University of Medical Sciences, Grant/Award Number: IR.MEDSAB. REC.1400.149 Keywords: cohort study | COVID‐19 | disease severity | PERSIAN cohort | risk factors ABSTRACT Background and Aims: Identifying the health‐related risk factors for COVID‐19 may improve future prevention strategies. This study aimed to investigate the association between pre‐pandemic health‐related factors and the prevalence and severity of COVID‐19 using data from the Sabzevar center of the PERSIAN cohort study. Methods: This retrospective cohort study included 4241 individuals aged 35–70 from the Sabzevar PERSIAN cohort. Health‐ related baseline data (demographic, anthropometric, biochemical, and chronic disease history) collected between 2017 and 2018 were linked with SARS‐CoV‐2 PCR test results and clinical outcomes (outpatient, hospitalization, or ICU admission/death) recorded in the health information system (HIS) between 2019 and early 2021. Descriptive and inferential statistical analyses were performed using t‐test, ANOVA, and Chi‐square tests. Results: SARS‐CoV‐2 positivity was confirmed in 423 individuals (10%) . Diabetes and lower education levels were significantly associated with SARS‐CoV‐2 infection (p < 0.05). Severity of disease was significantly higher among individuals aged ≥ 60, those with higher BMI, lower education, and comorbidities such as thyroid and ischemic heart disease. Baseline biochemical markers such as WBC, FBS, TG, and cholesterol levels were also associated with increased disease severity (p < 0.05) . Conclusion: Pre‐existing health‐related factors—especially chronic diseases and demographic characteristics like age and education—are associated with both the likelihood of infection and the severity of COVID‐19. These findings highlight the importance of targeted preventive strategies for at‐risk populations, particularly the elderly and those with underlying conditions. 1 | Introduction The global health landscape was dramatically altered with the emergence of SARS‐CoV‐2 in late 2019. Originating in Wuhan, China, the virus swiftly spread across the world, prompting one of the most significant public health responses in recent history [1]. The first country in the Middle East to experience the spread of COVID‑19 was Iran [2, 3]. Although mass vaccination campaigns and public health measures have since reduced the impact of the pandemic, COVID‐19 continues to affect millions globally. As of mid‐2024, the World Health Organization reports over 770 million confirmed cases and more than 7 million deaths [4] Over the past few years, a large body of research has identified various factors influencing COVID‐19 outcomes, including demographic, clinical, and lifestyle‐related variables [5–8] . Meta‐analyses and cohort studies worldwide have reported that This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for co

FAQs

What was the main objective of the retrospective cohort study?

To investigate the association between pre-pandemic health-related factors and both the prevalence and severity of COVID-19 using Sabzevar PERSIAN cohort data.

Which baseline health factors were linked to SARS-CoV-2 infection?

Diabetes and lower education levels were significantly associated with SARS-CoV-2 infection (p < 0.05).

What factors were associated with higher COVID-19 severity?

Severity was higher among people aged ≥ 60, those with higher BMI, lower education, and comorbidities such as thyroid and ischemic heart disease, as well as certain biochemical markers including WBC, FBS, TG, and cholesterol (p < 0.05).

Sep 30, 2026

Uploaded by Putri