Office of Research & Development |
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COVID-19 FACT SHEET |
In response to the COVID-19 pandemic, VA Research has undertaken a wide array of activities to support and advance VA's clinical and research missions and help Veterans affected by the disease. These efforts have spanned biomedical research, therapeutics and vaccine clinical trials, and data analyses that leverage VA's rich electronic health record system. VA Research has coordinated closely with internal VA and external partners—such as the National Institutes of Health and other federal agencies, and pharmaceutical companies—to identify the areas in which VA's nationwide research capacity, resources, and infrastructure could make the greatest contribution.
On this web page, we summarize recent and current COVID-19 research across the VA system.
VHA COVID-19 Research Dashboard
This interactive map shows active VA studies on COVID-19. Use the search bar or menus on the left to find studies on specific topics or locations. View larger version
Blood pressure control in Veterans declined during COVID-19 pandemic
A multi-institution team led by researchers at the White River Junction VA Medical Center in Vermont found that, in a group of nearly 1.65 million Veterans, 7% had a decline in blood pressure control during the COVID-19 pandemic. Most of the difference was explained by delays in follow-up care in Veterans whose blood pressure had been under control before the pandemic. Conversely, those who had uncontrolled high blood pressure before the pandemic were slightly more likely to gain control during the pandemic, suggesting providers focused more on people with uncontrolled blood pressure during this time. (Medical Care, Mar. 1, 2024)
Both COVID and flu increase long-term health risks, but COVID’s risk is greater
VA St. Louis researchers proved COVID-19 confers a higher risk of death and long-term health outcomes than the flu in nearly every organ system. The study included more than 81,000 VA patients admitted to the hospital with COVID-19 and nearly 11,000 admitted with seasonal influenza. Over an 18-month follow-up period, the risk of long-term health problems was only higher from the flu for the pulmonary system. However, both viruses caused a substantial risk in long-term health loss, prompting the researchers to call for greater prevention efforts and more attention to the needs of people with long-term health effects from either COVID-19 or influenza. (The Lancet Infectious Diseases, Dec. 14, 2023)
VA hospitals had lower COVID-19 mortality rates than community hospitals
Iowa City VA Health Care System researchers learned that Veterans hospitalized for COVID-19 in VA hospitals were less likely to die than those treated in community hospitals. The study included data on nearly 65,000 Veterans 65 years old or older who were hospitalized with COVID-19 between March 2020 and December 2021. Veterans in community hospitals had a 27% risk of death within 30 days of hospitalization, compared with an 18% risk for those admitted to VA hospitals. However, about 74% of Veterans were admitted to community hospitals rather than VA hospitals. The results show that quality of VA health care compares favorably to non-VA care, but more efforts may be needed to ensure Veterans receiving care in the community get the best quality care. (JAMA Network Open, May 1, 2023)
Risk of death from COVID-19 decreased, still higher than flu risk
St. Louis VA researchers learned that the risk of death from COVID-19 is still higher than the risk of death from the flu despite a decreasing COVID-19 mortality risk. The researchers analyzed VA hospital admissions between October 2022 and January 2023. Death rates for patients admitted for COVID-19 were 6%, while death rates for flu patients were 4%. In 2020, 17% to 21% of patients hospitalized with COVID-19 died, compared with 4% of patients hospitalized for the flu. The researchers attribute the decreased COVID-19 death rate to vaccinations and improved clinical care, as well changes in virus variants. (JAMA, April 6, 2023)
Suicidal ideations among Veterans fell during pandemic
Despite concerns that Veterans would be at a high risk of suicide because of the COVID-19 pandemic, a recent study by VA Connecticut researchers found that rates of suicidal thoughts in Veterans actually decreased after the onset of the pandemic. The study included more than 2,000 Veterans assessed for suicidal thoughts. In this group, 9.3% reported suicidal thoughts pre-pandemic in 2019, which dropped to 6.8% in 2020 before increasing slightly to 7.7% in 2022. Only 0.4% of participants attempted suicide during the pandemic, a rate consistent with pre-pandemic numbers. The factors most associated with new suicidal thoughts were higher education, lifetime substance use disorder, pre-pandemic loneliness, and lower pre-pandemic purpose in life. (JAMA Psychiatry, April 5, 2023)
Clinical Trials
Favorable antiviral effect of metformin on severe acute respiratory syndrome coronavirus 2 viral load in a randomized, placebo-controlled clinical trial of coronavirus disease 2019 . Bramante CT, Beckman KB, Mehta T, Karger AB, Odde DJ, Tignanelli CJ, Buse JB et al. Metformin reduced SARS-CoV-2 viral load 3.6-fold compared to placebo. Clin Infect Dis. 2024 May 1. Online ahead of print.
High-dose fluvoxamine and time to sustained recovery in outpatients with COVID-19: The ACTIV-6 randomized clinical trial . Stewart TG, Rebolledo PA, Mourad A, Lindsell CJ, Boulware DR, McCarthy MW et al. Among outpatients with mild to moderate COVID-19, treatment with fluvoxamine does not reduce duration of COVID-19 symptoms. JAMA. 2023 Nov 17. Online ahead of print.
Core warming of coronavirus disease 2019 patients undergoing mechanical ventilation: A pilot study . Bonfanti NP, Mohr NM, Willms DC, Bedimo RJ, Gundert E, Goff KL, Kulstad EB, Brewry AM. This pilot study suggests that core warming of patients with COVID-19 undergoing mechanical ventilation is feasible and appears safe. Inducing fever has potential to improve respiratory physiology in patients with COVID-19. Ther Hypothermia Temp Manag. 2023 Aug 2. Online ahead of print.
Intravenous aviptadil and remdesivir for treatment of COVID-19-associated hypoxaemic respiratory failure in the USA (TESICO): A randomised, placebo-controlled trial . Brown SM, Barkauska CE, Grund B, Sharma S, Phillips AN, Leither L, Peltran ID et al. Among patients with COVID-19-associated acute hypoxaemic respiratory failure, aviptadil did not significantly improve clinical outcomes up to day 90 when compared with placebo. Lancet Respir Med. 2023 Jun 19. Online ahead of print.
Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial . Bramante CT, Buse JB, Liebovits DM, Nicklas JM, Puskarich MA, Cohen K, Belani HK, Anderson BJ et al. Outpatient treatment with metformin reduced long COVID incidence by about 41% compared with placebo. Lancet Infect Dis. 2023 Jun 8. Online ahead of print.
Laboratory Studies
Intranasal neomycin evokes broad-spectrum antiviral immunity in the upper respiratory tract . Mao T, Kim J, Peña-Hernández MA, Valle G, Moriyama M, Luyten S, Ott IM et al. Prophylactic or therapeutic administration of neomycin provided significant protection against upper respiratory infection in a model of COVID-19. In healthy humans, intranasal application of neomycin-containing Neosporin ointment induced an effective gene response that could protect from COVID-19. Proc Natl Acad Sci U S A. 2024 Apr 30;121(18):e2319566121.
Evidence from whole genome sequencing of aerosol transmission of SARS-CoV-2 almost five hours after hospital room turnover . Charness ME, Gupta K, Linsenmeyer K, Strymish J, Madjarov R, Stack G. Airborne SARS-CoV-2 may transmit infection for over four hours, even in a hospital setting. Am J Infect Control. 2024 Apr 5. Online ahead of print.
Blood markers show neural consequences of long COVID-19 . Tang N, Kido T, Shi J, McCafferty E, Ford JM, Dal Bon K. This study shows chronic peripheral inflammation with increased stress after COVID-19 infection. Additionally, differentially expressed neurodegenerative proteins were identified in people recovering from COVID-19 regardless of persistent symptoms. Cell. 2024 Mar 8;13(6):478.
Viral and host factors are associated with mortality in hospitalized patients with COVID-19 . Aggarwal NR, Nordwall J, Braun DL, Chung L, Coslet J, Der T, Eriobu N et al. Researchers identified virus-specific, clinical, and biological variables strongly associated with COVID-19 mortality risk within 90 days, revealing potential pathogen and host-response therapeutic targets for acute COVID-19 disease. Clin Infect Dis. 2024 Feb 20. Online ahead of print.
Recombinant rod domain of vimentin reduces SARS-CoV-2 viral replication by blocking spike protein-ACE2 interactions . Lam FW, Brown CA, Ronca SA. Researchers created a form of the protein vimentin that decreases the viral replication of SARS-CoV-2 and has potential as a COVID-19 treatment. Int J Mol Sci. 2024 Feb 20;25(5):2477.
Data Analysis/Review
Defining the subtypes of long COVID and risk factors for prolonged disease: Population-based case-crossover study . Resendez S, Brown SH, Ruiz Ayala HS, Rangan P, Nebeker J, Montella D, Elkin PL. Researchers developed a long COVID definition and defined 17 medical-specialty subtypes. JMIR Public Health Surveill. 2024 Apr 30;10:e49841.
SARS-CoV-2 infection is associated with self-reported post-acute neuropsychological symptoms within six months of follow-up . Andronescu LR, Richard SA, Scher AI, Lindholm DA, Mende K, Ganesan A, Huprikar N et al. Participants with a history of COVID-19 were up to twice as likely to report cognitive impairment and fatigue. PLoS One. 2024 Apr 16;19(4):e0297481.
Impact of SARS-CoV-2 infection on long-term depression symptoms among Veterans . Chen JI, Bui D, Iwashyna TJ, Shahoumian TA, Hickok A, Shepherd-Banigan M et al. COVID-19 infection was associated with more depression symptoms among Veterans 18 months post-infection. J Gen Intern Med. 2024 Apr 16. Online ahead of print.
Risk of potential preventable hospitalization after SARS-CoV-2 infection . Govier DJ, Niederhausen M, Takata Y, Hickok A, Rowneki M, McCready H, Smith VA et al. An increased risk of preventable hospitalization in Veterans with COVID-19, which persisted for at least one year after initial infection, highlights the need for research on ways in which SARS-CoV-2 shapes post-infection care and engagement with the health system. JAMA Network Open. 2024 Apr 1;7(4):e245786.
Comparing frequency of booster vaccination to prevent severe COVID-19 by risk group in the United States . Park HJ, Gonsalves GS, Tan ST Kelly JD et al. More frequent COVID-19 booster vaccination in older age groups and the immunocompromised population would effectively reduce the burden of severe COVID-19. Nat Commun. 2024 Mar 6;15(1):1883.
Other Research
Self-reported impacts of the COVID-19 pandemic and economic inflation on the well-being of low-income U.S. Veterans . Tsai J, Hird R, Collier A. Low-income Veterans reported resilience in response to the COVID-19 pandemic and inflation. J Community Health. 2023 Dec;48(6):970-974.
Prevalence and associations of poor mental health in the third year of COVDI-19: U.S. population-based analysis from 2020 to 2022 . Kim J, Linos E, Rodriguez CI, Chen ML, Dove MS, Keegan TH. Mental health of U.S. adults worsened in the third year of COVID-19 compared to the beginning of the pandemic. Psychiatry Res. 2023 Dec:330:115622.
Using multi-modal electronic health record data for the development and validation of risk prediction models for Long COVID using the Super Learner algorithm . Jin W, Hao W, Shi X, Fritsche LG, Salvatore M, Admon AJ, Friese CR, Mukherjee B. Researchers created a composite risk score for post-acute sequelae of COVID prediction, which could contribute to the identification of individuals at higher risk for Long COVID and inform preventive efforts. J Clin Med. 2023 Nov 25;12(23):7313.
Modifying Whole Health services for successful telehealth delivery: Lessons from Veterans Health Administration’s rapid transition during the COVID-19 pandemic . Wu J, Bolton R, Anwar C, Bokhour BG, Khanna A, Mullur RS, Taylor SL, Hyde J. The COVID-19 pandemic catalyzed tele-Whole Health service implementation, utilization, and sustainment. The challenges faced and modifications made during this transition provide lessons learned for other health care systems as they attempt to implement telehealth services. J Integr Complement Med. 2023 Sep 1. Online ahead of print.
Development and cross-sectional evaluation of a text message protocol to support mental health well-being . Whealin JM, Saleem JJ, Vetter B, Roth J, Herout J. The Coping During COVID text messaging protocol can successfully support users’ self-care efforts during the COVID pandemic. Psychol Serv. 2023 Aug;20(3):657-667.
Commentary
Long Covid and impaired cognition – More evidence and more work to do . Al Aly Z, Rosen CJ. A deeper understanding of the biology of cognitive dysfunction after COVID-19 and how best to prevent and treat it are critical for addressing the needs of affected persons and preserving the cognitive health of the population. N Engl J Med. 2024;390:858-860.
Solving the puzzle of Long Covid . Al-Aly Z, Topol E. Studying Long COVID can lead to a deeper understanding of infection-associated chronic illnesses and optimize preparedness for future pandemics. Science. 2024 Feb 22;383(6685):830-832.
Global vaccine inequality threatens to unleash the next COVID-19 variant. Oehler RL, Vega VR. The emergence of COVID-19 variants from under-vaccinated regions is a direct consequence of the virus replicating unchecked through an unprotected population. Much more needs to be done to address global vaccine inequities and prevent the next devastating variant. Int J Infect Dis. 2022 Aug 18. Online ahead of print.
Estimated impact of the US COVID-19 vaccination campaign-Getting to 94% of deaths prevented. Jones M, Khader K, Branch-Elliman W. Substantial investments into national data infrastructure and research are needed to increase vaccine uptake and prevent more COVID-19 deaths. JAMA Netw Open. 2022 Jul 1;5(7):e2220391.
Approaches to long COVID care: the Veterans Health Administration experience in 2021. Gustavson AM, Eaton TL, Schapira RM, Iwashyna TH, Adly M, Purnell. Even well-resources health care systems such as VA are grappling with how to best address long COVID care. BMJ Mil Health. 2022 Jul 1;e002185.
As of November 2021, nearly 70 VA medical centers are involved in one or more COVID-19 clinical trials. Below are several examples. A full list of COVID-19 Clinical Trials in VA is also available.
NIAID provides COVID-19 antiviral drug for VA’s Veteran patients
VA research spells out COVID's down-the-road risks for cardiovascular and mental health
VA official encourages minorities to make educated decisions about participating in COVID-19 trials