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

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.