CORona (COVID-19) Follow Up Study: Epidemiology, Pathophysiology, Prediction, and Communication (CORFU)

• ClinicalTrials.gov Identifier: NCT05240742
• Recruitment Status: Enrolling by invitation
• First Posted: February 15, 2022
• Last Update Posted: April 8, 2022
• Sponsor: Maastricht University Medical Center
• Collaborators: Zuyderland Medical Centre; Leiden University Medical Center; UMC Utrecht; Radboud University Medical Center; Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA); Adelante, Centre of Expertise in Rehabilitation and Audiology
• Information provided by (Responsible Party): Maastricht University Medical Center

Study Description

Brief Summary:

The CORFU study, funded by ZonMW, is a prospective, multiple, cohort study with a maximum follow-up of 24 months after COVID-19. Dutch COVID-19 patients from 7 existing prospective cohorts, aiming and designed to conduct COVID-19 research, will be included in this study.

The CORFU study has 5 aims, divided into 4 work packages (WPs):

1. To describe the nature, severity, pattern and duration of long COVID complaints up to a maximum of two years after infection and its relationship with quality of life (WP1);
2. To describe the rehabilitation and corresponding activities for the treatment and improvement of complaints and quality of life (WP1);
3. To describe the pathophysiological processes that cause long COVID complaints, and the role of vulnerability/resilience factors (WP2);
4. To develop a prediction model for the persistence of complaints, with distinction between patients with and without pre-existing morbidity (WP3);
5. To develop a patient platform prototype in which patients can digitally consult their answers and compare their answers with reference populations (WP4, in collaboration with the EuroQol foundation).

The 7 cohorts participating in the CORFU study are: POPCOrn, COVAS, ELVIS, MaastrICCht, DC&TC, CAPACITY-COVID, and Adelante cohort.

(Clinical) baseline and follow-up data has been collected in these cohorts and will be used/aggregated to investigate CORFU study aims. In addition, questionnaires will be send to the (former) patients of the existing cohorts and patients will be asked about several domains such as persisting complaints and quality of life, at several moments, depending on when the patients have experienced COVID-19. Within this study a patient platform prototype will be developed, together with the EuroQol foundation, to be able to inform patients about the individual situation and course of disease.

Condition or disease	Intervention/treatment
COVID-19; Long COVID; Post COVID-19 Condition	Other: no intervention, the CORFU study conducts analyses based on data which has been prospectively collected (and aggregated when possible) in 7 existing cohorts

Study Design

• Study Type: Observational
• Estimated Enrollment: 5000 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: Persistent Complaints After COVID-19: Epidemiology, Pathophysiology, Prediction, and Communication, the CORona Follow Up (CORFU) Study
• Actual Study Start Date: October 1, 2021
• Estimated Primary Completion Date: December 31, 2022
• Estimated Study Completion Date: December 31, 2022

Groups and Cohorts

Group/Cohort	Intervention/treatment
Dutch COVID-19 patients; The study population consists of Dutch (former) COVID-19 patients who have been included in one of the cohorts and categorized in various subgroups: Patients who suffered from (confirmed) COVID-19 and were admitted to the hospital ward.; Patient who suffered from (confirmed) COVID-19 and were admitted to the ICU.; Patients who suffered from (confirmed or suspected) COVID-19 at home.; Patients who suffered from (confirmed) COVID-19 and were in need of inpatient or outpatient rehabilitation after infection at home or in the hospital (ward and/or ICU).	Other: no intervention, the CORFU study conducts analyses based on data which has been prospectively collected (and aggregated when possible) in 7 existing cohorts; (Clinical) baseline and follow-up data will be collected in the 7 existing cohorts. These data will be aggregated (when possible). The CORFU analyses will be conducted based on the aggregated data.; Other Name: Integrated database
Dutch controls who did not experience COVID-19; One of the cohorts, the POPCOrn cohort, is a community-based cohort which partly consists of controls who did not experience COVID-19	Other: no intervention, the CORFU study conducts analyses based on data which has been prospectively collected (and aggregated when possible) in 7 existing cohorts; (Clinical) baseline and follow-up data will be collected in the 7 existing cohorts. These data will be aggregated (when possible). The CORFU analyses will be conducted based on the aggregated data.; Other Name: Integrated database

Outcome Measures

Primary Outcome Measures :

1. Prevalence of long COVID complaints (based on data from all 7 cohorts) [ Time Frame: 24 months follow-up after COVID-19 ]
   Long COVID complaints include: exhaustion, respiratory complaints, and mental health complaints.

Secondary Outcome Measures :

1. (Health-related) Quality of life (measured in all 7 cohorts) [ Time Frame: 3, 6, 12, 18 and 24 months follow-up after COVID-19 ]
   Measured using the EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5L) questionnaire. Based on the Dutch tariff, scores range between -0.446 (worst) and 1.000 (best).
2. Anxiety and depression (measured in all 7 cohorts) [ Time Frame: 3, 6, 12, 18 and 24 months follow-up after COVID-19 ]
   Measured using the Hospital Anxiety and Depression Scale (HADS) questionnaire. Scores for both the Anxiety and Depression subscales range from 0 (best) to 21 (worst). A total subscale score of >8 points indicates considerable symptoms of anxiety or depression.
3. Prevalence of thrombo-embolic complications (not measured in all 7 cohorts) [ Time Frame: Measured during COVID-19 hospitalization (baseline), 3, 12, 24 months follow-up after COVID-19 ]

   Thrombo-embolic complications of interest are: acute pulmonary embolism, deep-vein thrombosis, ischemic stroke, myocardial infarction and systemic arterial embolism

   The diagnosis, and therefore, the prevalence of various thrombo-embolic complications will be measured based on a combination of cardiovascular and thrombosis and haemostasis biomarkers (such as troponin I, CK-MB, APTT, and D-dimer), radiologic imaging techniques (computed tomography pulmonary angiography (CTPA), compression ultrasonography (CUS), echocardiography, CT scan of the brain, and CT angiography of the carotid and intracerebral arteries), and electrocardiogram.

4. Physical functioning (not measured in all 7 cohorts) [ Time Frame: Measured during admission in the rehabilitation clinic (baseline), 3, 6, 12 months follow-up ]
   Measured using the 6 minute walk test (6MWT). The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity. An increase in the distance walked indicates improvement in basic mobility. The 6MWT result will be reported as a percentage of the predicted Dutch reference value which is based on the patient's age, sex, length and weight. A score <82% of the predicted value is considered deviant.
5. Prevalence of cardiovascular diseases (not measured in all 7 cohorts) [ Time Frame: Measured during COVID-19 hospitalization (baseline), 1 week, 1 month, and through study completion, an average of 2 years ]

   Cardiovascular diseases of interest are: coronary artery disease, heart failure, myocardial fibrosis, myocarditis, pericarditis.

   The diagnosis, and therefore, the prevalence of various cardiovascular diseases will be measured based on a combination of radiologic imaging techniques (such as cardiac magnetic resonance, CT and echocardiography), cardial biomarkers (such as troponin and CK-MB), and electrocardiogram.

6. Prevalence of endothelium dysfunction (not measured in all 7 cohorts) [ Time Frame: Measured during COVID-19 hospitalization (baseline), 3, 12 months after COVID-19 ]
   Measured using several biomarkers (such as endothelin-1, coagulation and inflammatory cytokines).
7. Disease severity during intensive care unit stay (not measured in all 7 cohorts) [ Time Frame: Measured on the day of admission with COVID-19 to the intensive care unit (baseline), followed by daily measurement until discharge, an average of 18 days ]
   Measured using the Sequential Organ Failure Assessment (SOFA) score which is based on the degree of dysfunction of six organ systems. For each organ system, scores range between 0 (best) to 4 (worst). A sum score per day at the intensive care unit can be calculated, which ranges between 0 (best) and 24 (worst).

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes
• Sampling Method: Probability Sample

Study Population

The study population consists of Dutch (former) COVID-19 patients and non-COVID-19 controls, who have been included in one of the cohorts and categorized in five subgroups:

• Patients who suffered from (confirmed) COVID-19 and were admitted to the hospital ward.
• Patient who suffered from (confirmed) COVID-19 and were admitted to the ICU.
• Patients who suffered from (confirmed or suspected) COVID-19 at home.
• Patients who suffered from (confirmed) COVID-19 and were in need of inpatient or outpatient rehabilitation after infection at home or in the hospital (ward and/or ICU).
• Controls who did not suffer from (confirmed or suspected) COVID-19.

Criteria

All 7 existing cohorts have specific inclusion and exclusion criteria.

For the CORFU study, in general, the criteria are:

Patients with proven or suspected COVID-19:

• Confirmed (or suspected) COVID-19 - both home-isolated patients and patients who were admitted to the hospital ward and/or ICU;
• Included in one of the seven cohorts from March 2020 onwards;
• Aged 18 years or older;
• Mastering the Dutch language sufficiently to answer the questionnaires;
• Informed consent.

Controls who did not experience COVID-19:

• Aged 18 years or older;
• Mastering the Dutch language sufficiently to answer the questionnaires;
• Informed consent.

There were no exclusion criteria.

Contacts and Locations

Locations

Netherlands

Maastricht University Medical Center+

Maastricht, Netherlands, 6229HX

Sponsors and Collaborators

Maastricht University Medical Center

Zuyderland Medical Centre

Leiden University Medical Center

UMC Utrecht

Radboud University Medical Center

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Adelante, Centre of Expertise in Rehabilitation and Audiology

Investigators

• Principal Investigator: Sander MJ van Kuijk, PhD; Maastricht University Medical Center
• Study Director: Chahinda Ghossein-Doha, MD, PhD; Maastricht University Medical Center

More Information

Additional Information:

CAPACITY COVID-19: Registry of patients with COVID-19 including cardiovascular risk and complications 

Publications:

Bels JLM, van Kuijk SMJ, Ghossein-Doha C, Tijssen FH, van Gassel RJJ, Tas J, Collaborators M, Schnabel RM, Aries MJH, van de Poll MCG, Bergmans DCJJ, Meex SJR, van Mook WNKA, van der Horst ICC, van Bussel BCT. Decreased serial scores of severe organ failure assessments are associated with survival in mechanically ventilated patients; the prospective Maastricht Intensive Care COVID cohort. J Crit Care. 2021 Apr;62:38-45. doi: 10.1016/j.jcrc.2020.11.006. Epub 2020 Nov 17.

Dutch COVID & Thrombosis Coalition (DCTC). Early effects of unfractionated heparin on clinical and radiological signs and D-dimer levels in patients with COVID-19 associated pulmonary embolism: An observational cohort study. Thromb Res. 2021 Apr;200:130-132. doi: 10.1016/j.thromres.2021.01.023. Epub 2021 Feb 2. No abstract available.

Dutch COVID & Thrombosis Coalition; Kaptein FHJ, Stals MAM, Grootenboers M, Braken SJE, Burggraaf JLI, van Bussel BCT, Cannegieter SC, Ten Cate H, Endeman H, Gommers DAMPJ, van Guldener C, de Jonge E, Juffermans NP, Kant KM, Kevenaar ME, Koster S, Kroft LJM, Kruip MJHA, Leentjens J, Marechal C, Soei YL, Tjepkema L, Visser C, Klok FA, Huisman MV. Incidence of thrombotic complications and overall survival in hospitalized patients with COVID-19 in the second and first wave. Thromb Res. 2021 Mar;199:143-148. doi: 10.1016/j.thromres.2020.12.019. Epub 2020 Dec 30.

van Gassel RJJ, Bels JLM, Raafs A, van Bussel BCT, van de Poll MCG, Simons SO, van der Meer LWL, Gietema HA, Posthuma R, van Santen S. High Prevalence of Pulmonary Sequelae at 3 Months after Hospital Discharge in Mechanically Ventilated Survivors of COVID-19. Am J Respir Crit Care Med. 2021 Feb 1;203(3):371-374. doi: 10.1164/rccm.202010-3823LE. No abstract available.

Kruip MJHA, Cannegieter SC, Ten Cate H, van Gorp ECM, Juffermans NP, Klok FA, Maas C, Vonk-Noordegraaf A; Dutch COVID Thrombosis Coalition study group. Caging the dragon: Research approach to COVID-19-related thrombosis. Res Pract Thromb Haemost. 2021 Mar 8;5(2):278-290. doi: 10.1002/rth2.12470. eCollection 2021 Feb.

Leijte WT, Wagemaker NMM, van Kraaij TDA, de Kruif MD, Mostard GJM, Leers MPG, Mostard RLM, Buijs J, van Twist DJL. [Mortality and re-admission after hospitalization with COVID-19]. Ned Tijdschr Geneeskd. 2020 Nov 19;164:D5423. Dutch.

Long D, Haagsma JA, Janssen MF, Yfantopoulos JN, Lubetkin EI, Bonsel GJ. Health-related quality of life and mental well-being of healthy and diseased persons in 8 countries: Does stringency of government response against early COVID-19 matter? SSM Popul Health. 2021 Sep 1;15:100913. doi: 10.1016/j.ssmph.2021.100913. eCollection 2021 Sep.

Tas J, van Gassel RJJ, Heines SJH, Mulder MMG, Heijnen NFL, Acampo-de Jong MJ, Bels JLM, Bennis FC, Koelmann M, Groven RVM, Donkers MA, van Rosmalen F, Hermans BJM, Meex SJ, Mingels A, Bekers O, Savelkoul P, Oude Lashof AML, Wildberger J, Tijssen FH, Buhre W, Sels JEM, Ghossein-Doha C, Driessen RGH, Kubben PL, Janssen MLF, Nicolaes GAF, Strauch U, Geyik Z, Delnoij TSR, Walraven KHM, Stehouwer CD, Verbunt JAMCF, Van Mook WNKA, van Santen S, Schnabel RM, Aries MJH, van de Poll MCG, Bergmans D, van der Horst ICC, van Kuijk S, van Bussel BCT. Serial measurements in COVID-19-induced acute respiratory disease to unravel heterogeneity of the disease course: design of the Maastricht Intensive Care COVID cohort (MaastrICCht). BMJ Open. 2020 Sep 29;10(9):e040175. doi: 10.1136/bmjopen-2020-040175.

Wiertz CMH, Vints WAJ, Maas GJCM, Rasquin SMC, van Horn YY, Dremmen MPM, Hemmen B, Verbunt JA. COVID-19: Patient Characteristics in the First Phase of Postintensive Care Rehabilitation. Arch Rehabil Res Clin Transl. 2021 Jun;3(2):100108. doi: 10.1016/j.arrct.2021.100108. Epub 2021 Feb 4.

• Responsible Party: Maastricht University Medical Center
• ClinicalTrials.gov Identifier: NCT05240742
• Other Study ID Numbers: METC2021-2990
• First Posted: February 15, 2022
• Last Update Posted: April 8, 2022
• Last Verified: March 2022

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Undecided

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Maastricht University Medical Center:

Epidemiology; Pathophysiology; Prediction model; Patient platform

Additional relevant MeSH terms:

COVID-19; Respiratory Tract Infections; Infections; Pneumonia, Viral; Pneumonia; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases