VA research during the COVID-19 pandemic
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.
Few differences in safety of Moderna, Pfizer COVID-19 vaccines
Both the Moderna and Pfizer COVID-19 vaccines have a low risk of adverse events, found a study by VA Boston researchers. The study looked at data on more than 400,000 Veterans who were vaccinated. Risks were low after 38 weeks for either vaccine. Veterans receiving the Moderna vaccine were slightly less likely to experience stroke, heart attack, blood clots, or kidney damage. However, the difference was less than two-tenths of one percent. The results show that either vaccine is safe and effective for individuals, say the researchers, but the differences may help inform future population-level vaccination efforts. (JAMA Internal Medicine, June 13, 2022)
Airborne virus linked to hospital COVID-19 spread
Hospital COVID-19 infection may result from airborne virus particles introduced by employees and patients in common hospital areas, according to a study by VA Boston researchers and colleagues. The researchers studied the genome sequence of viruses from infected nurses and patients during a hospital COVID-19 outbreak. They compared these to virus particles from air samples. They learned that viruses found in nurses and patients were genetically identical to virus particles in the air. The findings suggest that very small, aerosolized virus particles can lead to COVID-19 spread in hospitals, according to the researchers. Isolating infected health care providers and improving ventilation and masking could help decrease the spread, they say. (JAMA Network Open, June 8, 2022)
Vaccines only modestly reduce long COVID risk in breakthrough infection patients
Vaccines only modestly reduce the risk of long COVID in patients with breakthrough infection, according to a large study by VA St. Louis researchers. Long COVID refers to a wide range of ongoing health conditions that some people experience after recovering from COVID-19. Researchers studied data on nearly 34,000 people who had breakthrough COVID-19 infections after being vaccinated. They compared this group to more than 13 million controls. People with breakthrough infection had lower rates of death and long COVID symptoms six months after infection, compared to those who had never been vaccinated. However, breakthrough patients had a significantly higher risk of death and health problems compared to patients who never contracted COVID-19. These patients experienced many different symptoms, including cardiovascular, clotting, kidney, and mental health problems. The results show an urgent need to develop additional layers of protection beyond vaccines to protect against the long-term consequences of COVID-19, say the researchers. (Nature Medicine, May 25, 2022
Genetic links between severe COVID-19 and other diseases
A VA Million Veteran Program study identified genetic links between COVID-19 severity and certain serious medical conditions. Researchers analyzed genetic and health record data on more than 650,000 Veterans who volunteered for MVP. They compared gene variations previously found to be linked severe COVID-19 risk with gene variants connected to other conditions. The analysis showed that gene variants linked to severe COVID-19 are also linked to medical conditions known to be COVID-19 risk factors. The strongest links were found for venous embolism and thrombosis, as well as type 2 diabetes and ischemic heart disease. The study also showed genetic links between severe COVID-19 and neutropenia—low white blood cell count—in Veterans of African and Hispanic ancestry. This link was not seen in Veterans of European ancestry. Conversely, gene variants associated with severe COVID-19 were associated reduced risk of immune-related conditions such as lupus and rheumatoid arthritis. The findings shed light on genetic risk for COVID-19 and could lead to paths for new treatments, say the researchers. (PLOS Genetics, April 28, 2022)
Older and underweight Veterans at higher risk of death from COVID-19
Older and underweight Veterans had a higher risk of death from COVID-19, in a study by Salt Lake City VA researchers and colleagues. Researchers studied data on more than 400,000 Veterans who tested positive for COVID-19 in 2020 and 2021. Those 65 and older and those who were underweight were more likely to require mechanical ventilation and die in the hospital, compared with younger Veterans and those with normal weight. Veterans 85 and older had an almost five times greater rate of death. Asian and American Indian/Alaska Native Veterans also had higher risk of ventilation and death compared to white Veterans. Black Veterans had a 31% higher risk than white Veterans of hospitalization, but did not have a higher risk of death. Hospitalization, ventilation, and death rates decreased for all groups over time. The results show that age and weight are important variables to consider in COVID-19 risk, say the researchers. (Annals of Epidemiology, April 21, 2022)
View all studies
Selected Studies by VA Researchers
Baricitinib versus dexamethasone for adults hospitalised with COVID-19 (ACTT-4): a randomized, double-blind placebo-controlled trial. Wolfe CR, Tomashek KM, Patterson TF, Gomez CA, Marconi VA, Jain MK, Yang OO et al. In hospitalized patients with COVID-19 requiring supplemental oxygen, baricitinib plus remdesivir and dexamethasone plus remdesivir resulted in similar mechanical ventilation-free survival by day 29, but dexamethasone was associated with significantly more adverse events. Lancet Respir Med. 2022 May 23. Online ahead of print.
A multicenter evaluation of the Seraph 100 microbind affinity blood filter for the treatment of severe COVID-19. Chitty SA, Mobbs S, Rifkin BS, Stogner SW, Lewis MS, Betancort J, DellaVolpe J et al. Findings suggest that broad spectrum, pathogen agnostic blood purification can be safely deployed to meet new pathogen threats while awaiting targeted therapies and vaccines. Crit Care Explor. 2022 Mar 25;4(4):e0662.
Efficacy and safety of baricitinib plus standard care for the treatment of critically ill hospitalised adults with COVID-19 on invasive mechanical ventilation or extracorporeal membrane oxygenation: An exploratory, randomised placebo-controlled trial. Ely EW, Ramanan AV, Kartman CE, de Bono S, Liao R, Piruzeli MLB, Goldman JD et al. In a small exploratory study of critically ill, hospitalized COVID-19 patients on ventilation or extracorporeal membrane oxygenation, treatment with baricitinib reduced mortality. Lancet Respir Med. 2022 Feb 3. Online ahead of print.
The effect of povidone-iodine nasal spray on COVID-19 nasopharyngeal viral load in patients: A randomized control trial. Zarabanda D, Vukkadala N, Phillips KM, Qian ZJ, Mfuh KO, Hatter M, Lee IT et al. Data suggest that dilute version of povidone-iodine nasal spray are safe for topical use in the nasal cavity, but that the spray does not demonstrate virucidal activity in COVID-19 positive outpatients. Laryngoscope. 2021 Nov 1. Online ahead of print.
Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER): A randomised, double-blind, parallel-group, placebo-controlled phase 3 trial. Marconi VC, Ramanan AV, de Bono S, Kartman CE, Krishnan V, Liao R, Piruzeli ML et al. Although there was no significant reduction in the frequency of disease progression overall, treatment with baricitinib in addition to standard of care (including dexamethasone) had a similar safety profile to that of standard care alone, and was associated with reduced mortality in hospitalized adults with COVID-19. Lancet Respir Med. 2021 Aug 31. Online ahead of print.
Simulation of COVID-19 symptoms in a genetically engineered mouse model: Implications for the long haulers. Singh M, Pushpakumar S, Bard N, Zheng Y, Homme RP, Mokshagundam SPL, Tyagi SC. The engineered mouse appears to be a suitable model for studying COVID-19 and finding appropriate prevention and treatment methods. Mol Cell Biochem. 2022 Jun 22. Online ahead of print.
Multiomic analysis reveals cell-type-specific molecular determinants of COVID-19 severity.
Zhang S, Cooper-Knock J, Weimer AK, Shi M, Zozhaya L, Unutmaz D, Harvey C et al. The study identified a possible genomic basis for COVID-19 severity. Cell Syst. 2022 Jun 3. Online ahead of print.
COVID-19 vaccine booster dose needed to achieve Omicron-specific neutralisation in nursing home residents. Canaday DH, Oyebanji OA, White E, Keresztesy D, Payne M, Wilk D, Carias L et al. Booster vaccination significantly increased Omicron-specific COVID-19 immune response in nursing home residents and health care workers. EBioMedicine. 2022 May 20;80:104066.
Inhibition of IRAK4 dysregulates SARS-CoV-2 spike protein-induced macrophage inflammatory and glycolytic reprogramming. Umar S, Palasiewicz K, Meyer A, Kumar P, Prabhakar BS, Volin MV, Rahat R et al. The study explores the molecular mechanism of how the SARS-CoV-2 virus affects the inflammatory response through the IRAK4 enzyme. Cell Mol Life Sci. 2022 May 19;79(6):301.
Interleukin-6 elevation is a key pathogenic factor underlying COVID-19-associated heart rate-corrected QT prolongation. Lazzerrini P, Accioli R, Acampa M, Zhang WH, Verrengia D, Cartocci A, Bacarelli MR et al. In severe COVID-19, systemic inflammatory activation can promote QT interval prolongation via IL-6 elevation, leading to ventricular electric remodeling. Front Cardiovasc Med. 2022 May 19;9:893681.
Pharmacogenetic variants and risk of remdesivir-associated liver enzyme elevations in Million Veteran Program participants hospitalized with COVID-19. Tuteja S, Yu Z, Wilson O, Chen HC, Wehdt F, Chung CP, Shah SC et al. Remdesivir-associated elevations of the liver enzyme alanine aminotransferase appear to be multifactorial, and further studies are needed. Clin Transl Sci. 2022 Jun 9. Online ahead of print.
Clinical characteristics and social determinants of health associated with 30-day hospital readmission of patients with COVID-19. Wiley Z, Kulshreshtha A, Li D, Kubes J, Kandiah S, Leung S, Kobaidze K et al. Patients who received remdesivir, were cared for in an ICU, and resided in ZIP codes with higher proportions of residence with increased social support had lower odds of hospital readmission. J Investig Med. 2022 Jun 1. Online ahead of print.
Racial and ethnic discrepancy in pulse oximetry and delayed identification of treatment eligibility among patients with COVID-19. Fawzy A, Wu TD, Wang K, Robinson ML, Farha J, Bradke A, Golden SH et al. Racial and ethnic biases in pulse oximetry accuracy were associated with greater occult hypoxemia in Asian, Black, and non-Black Hispanic patients with COVID-19, which was associated with significantly delayed or unrecognized eligibility for COVID-19 therapies among Black and Hispanic patients. JAMA Intern Med. 2022 May 31. Online ahead of print.
Variation in call volume to the Veterans Crisis Line by women and men Veterans prior to and following onset of the COVID-19 pandemic. Dichter ME, Chhatre S, Hoffmire C, Bellamy S, Montgomery AE, McCoy I. The onset of the COVID-19 pandemic in 2020 was not associated with a spike in calls by Veterans to the Veteran Crisis Line. The pandemic may have led to an increase in calls by some as well as a decrease in calls by others. J Psychiatr Res. 2022 May 23;151:561563.
Evaluating primary endpoints for COVID-19 therapeutic trials to assess recovery. Douin DJ, Grandits G, Phillips A, Aggarwal NR, Baker J, Brown SM et al. Among patients hospitalized with COVID-19, 20% had clinically significant post-discharge events within 90 days after study, in patients that would be considered “recovered” using the hospital discharge approach. Clinical trials should extend follow-up times to assess recovery more accurately. Am J Respir Crit Care Med. 2022 May 17. Online ahead of print.
Factors influencing uptake of telemental health via videoconferencing at high and low adoption sites within the Department of Veterans Affairs during COVID-19: A qualitative study. Connolly SL, Sullivan JL, Lindsay JA, Shimada SL, Heyworth L, Weaver KR, Miller CJ. A survey identified positive influences such as convenience and negative influence such as complexity that affected the uptake of videoconferencing for health care. Implement Sci Commun. 2022 Jun 20;3(1):66.
Self-reported health behaviors and risk perceptions following the COVID-19 vaccination rollout in the USA: An online survey study. Thorpe A, Fagerlin A, Drews FA, Shoemaker H, Scherer LD. COVID-19 vaccine rollout did not result in the rapid abandonment of protective behaviors or dramatic uptake of risk-increasing behaviors. Public Health. 2022 May 18;208:68-71.
Communications to promote interest and confidence in COVID-19 vaccines. Thorpe A, Fagerlin A, Drews FA, Butler J, Stevens V, Riddoch MS, Scherer LD. Messages with information on the benefits of vaccination, reframing the likelihood of side effects, and emphasizing that post-vaccine symptoms indicate the vaccine is working increased vaccine interest. Veterans were more interested and confident in vaccines than non-Veterans. Am J Health Promot. 2022 Apr 12. Online ahead of print.
An assessment of Veterans attitudes and willingness to receiving the COVID-19 vaccine: A mixed methods study. Gardner J, Brown G, Vargas-Correa J, Weaver F, Rubinstein I, Gordon HS. The study illustrates the complexity of patients’ deliberation about COVID-19 vaccination and may help physicians and other health care providers understand patients’ perspectives about vaccination. BMC Infect Dis. 2022 Mar 29;22(1):308.
Cognitive and functional abilities in an older adult Veteran before and after contracting COVID-19. Okolichany R, Padala PR, Mooney S. No patterns of cognitive changes occurred in a 76-year-old Veteran before and after he contracted COVID-19. High levels of resilience, social support, and exercise, coupled with lower levels of perceived stress and loneliness may protect against cognitive and functional decline in older adults who contract COVID-19. J Alzheimers Dis Rep. 2022 Mar 25;6(1):115-120.
Awakening: The unveiling of historically unaddressed social inequities during the COVID-19 pandemic in the United States. Andrasik MP, Maunakea AK, Oseso L, Rodriguez-Diaz CE, Wallace S, Walters K, Yukawa M. Long-standing inequities paved the way for the disproportionate burdens of COVID-19 among people of color across the country. Infect Dis Clin North Am. 2022 Jun;36(2):295-308.
Smoking enhances suicide risk—A significant role in the COID-19 pandemic? Sher L. Tobacco smoking cessation may be needed to reduce suicidal behavior during and after the COVID-19 pandemic. QJM. 2022 Jan 5;114(11):767-769.
Chasing the storm: Recruiting non-hospitalized patients for a multi-site randomized controlled trial in the United States during the COVID-19 pandemic. Hu K, Tardif JC, Huber M, Daly M, Langford AT, Kirby R, Rosenberg Y et al. Researchers share difficulties and strategies for recruiting participants to COVID-19 trials during the pandemic. Clin Transl Sci. 2021 Dec 24. Online ahead of print.
Suicide prevention in the COVID-19 era. Rothman S, Sher L. With the COVID-19 pandemic affecting mental health and creating social isolation, preventative measures need to be implemented universally. Prev Med. 2021 Nov;152(Pt 1):106547.
Conquering COVID-19: How global vaccine inequality risks prolonging the pandemic. Oehler RL, Vega VR. Wealthier countries must do more to eliminate the inequality that exists in COVID-19 vaccine availability in less-developed nations. As long as the pandemic rages in any corner of the globe, the world will never be truly rid of COVID-19. Open Forum Infect Dis. 2021 Sep 9;8(10):ofab443.
Active and Recently Completed Research
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.
- VA CURES—The wide-reaching VA CURES master protocol, launched in August 2020, enables a series of clinical trials across VA. The initial study examined the effects of convalescent plasma. VA CURES stands for “Coronavirus Research and Efficacy Studies.” The initiative aims to give Veterans faster access to potential COVID-19 treatments and to test their effectiveness. As a master protocol, VA CURES offers a standardized framework for studies on many potential treatments for COVID-19, without the need for a new study design and protocol each time. VA CURES now serves as a partnering network for trials and VA trial sites.
- VA has been part of two major national research initiatives on COVID-19 vaccines and therapeutics: Operation Warp Speed (OWS) and the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) initiative.
- Through OWS and other efforts, VA was an active participant in several clinical trials designed to evaluate potential COVID-19 vaccines. These trials have included:
- The Moderna/COVE trial, which took place at one VA site. In December 2020, Moderna obtained an emergency use authorization for its vaccine from the FDA.
- The AstraZeneca trial, now closed to enrollment.
- The Janssen ENSEMBLE trial, which included 17 VA sites and is now closed to enrollment. The vaccine received FDA emergency use authorization in late February 2021.
- The Pfizer trial, now closed to enrollment. In December 2020, Pfizer obtained an emergency use authorization for its vaccine from the FDA.
- The Novavax trial, now closed to enrollment in VA.
- ACTIV, led by the National Institutes of Health, brings together multiple groups within VA, the Department of Health and Human Services, and the Department of Defense, as well as outside organizations, to conduct large-scale clinical trials. VA is participating in two ACTIV protocols:
- ACTIV-2 is a trial platform for outpatients with mild COVID-19 with risk of worsening illness. It is investigating multiple new drugs for potential COVID-19 treatment through clinical trials. ACTIV-2 has completed studies on six monoclonal antibodies, an antiviral, and an immunomodulator, and is currently studying multiple other possible therapeutics. Six VA sites have participated in ACTIV-2.
- ACTIV-3 is a trial platform for inpatients with COVID-19. It is designed to test neutralizing monoclonal antibody and antiviral treatments in rapid succession. ACTIV-3 has completed trials of four monoclonal antibodies and one antiviral, and is enrolling participants for testing of a new antiviral. ACTIV-3 trials are also investigating patients with severe COVID-19 pneumonia, the drugs aviptadil and remdesivir alone or in combination as a COVID-19 treatment, and strategies for post-COVID-19 illness vaccination. Twenty VA sites have enrolled patients in ACTIV-3 studies.
- CDC SUPERNOVA—In partnership with the Centers of Disease Control and Prevention, VA has undertaken the Surveillance Platform for Enteric and Respiratory Infectious Organisms at the VA (SUPERNOVA) project. A network of five VA medical centers is conducting active and passive surveillance for acute gastroenteritis, a symptom of COVID-19 and other illnesses. Monitoring includes both laboratory-confirmed testing for SARS-CoV-2 and norovirus, as well as electronic health system data from patients’ charts. The project will help track pathogen distribution over time.
- Trials with industry—VA took part in a number of industry-sponsored studies of promising medications for COVID-19. These included, for example, studies of the drug tocilizumab with Hoffman-La Roche, and sarilumab with Regeneron. Both drugs are used in arthritis care and block an inflammatory protein known as IL-6.
- Remdesivir trial with NIH—VA sites took part in a randomized, placebo-controlled study of remdesivir and other medications for hospitalized patients with COVID-19, sponsored by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.
- PURIFY blood filter technology—Scientists with VA, DOD, and partner institutions are testing a new technology called the Seraph 100 blood filter that may be able to filter out viral particles and harmful molecules from the bloodstreams of COVID-19 patients. The PURIFY program is a four-part, multi-site clinical evaluation that involves 13 participating sites across the U.S., including one VA medical center. Preliminary data suggests that severely ill patients treated with the Seraph filter had lower mortality rates than other patients.
- Natural history study—VA is collaborating with the Department of Defense on an observational, natural history study of COVID-19 illness titled “Epidemiology, Immunology and Clinical Characteristics of COVID-19” (EPIC3). Researchers are collecting data and biospecimens from volunteers for up to two years to better understand the clinical course of COVID-19. The study also aims to establish repositories of clinical data and specimens, along with a participant registry, to support future studies of COVID-19 and other health conditions. Recruitment at up to 16 sites began in July 2020.
- COVID-19 and cancer—The National Cancer Institute COVID-19 in Cancer Patients Study, or NCCAPS, is a natural history study of COVID-19 in people with cancer. In a natural history study, researchers follow people and collect medical and other information about them over time to learn more about how a disease and its symptoms develop and change. Diagnosis and treatment of a disease are not part of natural history studies. The knowledge gained through this study will help doctors better manage treatment for people with cancer and COVID-19 in the future. As part of the NCCAPS study, researchers will collect blood samples, medical information, and medical images from 2,000 people with cancer who also have COVID-19. Each person will be followed for up to two years to help doctors understand how cancer affects COVID-19 and COVID-19 affects cancer. The study is recruiting volunteers nationwide, including at 11 VA locations.
Data analysis projects
- COVID-19 Insights Partnership—VA is a key partner in the COVID-19 Insights Partnership, along with the departments of Energy (DOE) and Health and Human Services (HHS). The initiative aims to coordinate and share health data as well as research and expertise to aid in the fight against COVID-19.The Partnership creates a framework for VA and HHS to use DOE’s world-leading high-performance computing and artificial intelligence resources to conduct COVID-19 research and analyze health data.
- Million Veteran Program—VA’s Million Veteran Program (MVP) has deployed a COVID-19 questionnaire to participants to collect information about their experience with COVID-19. In addition, MVP has prioritized a series of research questions to examine the genetic basis of infection by SARS CoV-2; complications of infection; disease severity and outcomes; and response to various medications. MVP is working to identify disease mechanisms and new treatment targets for COVID-19. Given MVP's racially and ethnically diverse participant population (~ 20% African American and 7% Hispanic), the influence of race and ethnicity on disease susceptibility, severity, and outcomes is an integral part of the analyses.
- VA SHIELD—The VA Science and Health Initiative to Combat Infectious and Life-Threatening Diseases (VA SHIELD) is a comprehensive, secure biorepository of specimens and associated data related to COVID-19 and other emerging diseases. The specimens and data are available to authorized investigators to advance scientific understanding and support of developing diagnostic, therapeutic, and preventive strategies for use in clinical care.
- VA SeqCURE—VA SeqCURE, short for VA Sequencing Collaborations United for Research and Epidemiology, is a network of VA research labs funded by the American Rescue Plan of 2021. Five VA sites are included: Cleveland, Durham, Iowa City, Boise, and Temple. The network will generate genetic sequencing data for public health surveillance. Projects under VA SeqCURE will include studying the effectiveness of COVID-19 vaccines, analyzing antimicrobial-resistance organisms, and working with VA SHIELD to establish protocols for handling biospecimens.
- Synthesizing evidence from publications—Researchers from the HSR&D Evidence Synthesis Program are working to help synthesize publications about the novel coronavirus and COVID-19, and to translate that information quickly into usable guidance for clinicians. The ESP’s completed reports can be found here.
Additional evidence reviews can be found at www.covid19reviews.org. The goal of this resource is to capture the work of evidence synthesis groups, like VA’s, around the US and the globe, and thereby avoid duplication of effort and maximize the contribution of these researchers. The catalog is maintained by the VA ESP Coordinating Center in Portland, Oregon. New evidence reviews and reviews in progress are identified through literature searching and correspondence with colleagues and content experts. The team has also set up a listserv to facilitate collaboration among systematic review researchers.
- International collaboration—Researchers with the VA Informatics and Computing Infrastructure team are participating in the Observational Health Data Sciences and Informatics (or OHDSI, pronounced "Odyssey") program, an international, interdisciplinary collaborative to maximize the value of health data through large-scale analytics.
- COVID-19 Observational Research Collaboratory (CORC)—A VA research initiative is bringing together VA experts to analyze the use and effects of COVID-19 drugs with clinical partners interested in the safety and efficiency of these therapies. VA’s Health Services Research and Development Service, Clinical Science Research and Development Service, and Cooperative Studies Programestablished the collaboratory soon after the pandemic took hold earlier this year. CORC is conducting a national three-year study of VA inpatients and outpatients diagnosed with COVID-19, compared with matched controls. The study will use electronic health record data and surveys to assess risk factors and long-term symptoms.
- Dementia patients—VA researchers in Providence have funding from the National Institute on Aging to study COVID-19 risk factors and outcomes among Veterans with dementia who live in VA community living centers.
Other research activities
- COVID-19 and mental health—In addition to studying how to prevent or treat COVID-19, VA is examining the mental health impact of the pandemic. To date, ORD has funded nearly 30 studies looking at mental, behavioral, and social health and COVID-19. Some are new projects focused wholly on COVID-19, whereas others are supplements to existing projects that are broader in scope. The following study titles indicate some of the themes being explored:
- Inflammatory and Mental Health Sequelae of COVID-19 in Veterans
- An Integrative Technology Approach to Home-Based Conjoint Therapy for PTSD
- Impact of COVID-19 On Mental Health, Relationship Functioning and VA Telemental Health Service Use in a Longitudinal Cohort Study
- Impact of COVID-19 and Social Distancing on Mental Health and Suicide Risk in Veterans
- Piloting a Self-Help Intervention to Improve Veteran Mental Health During the COVID-19 Pandemic
- Mixed-Methods Pilot Study of the Impacts of Telemental Healthcare for High-Risk Veterans with Opioid Use Disorder During COVID-19
- Adapting Caring Contacts to Counteract Adverse Effects of Social Distancing among High-Risk Veterans During the COVID-19 Pandemic
- Virtual Pain Care for High-Risk Veterans on Opioids During COVID-19 (and Beyond)
- Changes in the Delivery of Evidenced-Based Psychotherapies for Depression and PTSD as the Result of the COVID-19 Pandemic
- Impacts of COVID-19 on African American Veterans with Chronic Pain
- Biomedical studies—VA biomedical researchers are part of the fight against COVID-19. The following project titles illustrate the scope of the VA lab studies already completed or being conducted to better understand how the virus works, and to identify new ways to keep it from spreading and causing disease.
- 3D-Printed Respirator Mask Performance with and without Virus Inactivation
- A Safe Validation to Test the Efficacy of Disinfectants on Reusable 3D-Printed Face Masks During the COVID-19 Pandemic
- Leukocyte Rewiring as a Mechanism of COVID-19-ARDS
- Viral and Immune Dynamics of Sars-Cov-2 Infection in Moderate and Severe COVID-
- Predictive Immune and Airway Monitoring in Healthcare Workers and Hospitalized COVID-19 Patients
- Boosting the VA supply chain—Rehabilitation researchers are helping to build a more resilient supply chain for VA. Researchers from several centers are involved, such as the Human Engineering Research Laboratories (HERL) in Pittsburgh; the Center for Limb Loss and Mobility at the Puget Sound VA; the Minneapolis Adaptive Design and Engineering Program; and the Advanced Platform Technology Center in Cleveland. Partners in this effort include the VA Innovation Ecosystem, the U.S. Food and Drug Administration, the National Institutes of Health, and America Makes. These researchers and their colleagues have been designing, fabricating, and evaluating personal protective equipment (PPE) and other supplies to support VA’s response to this pandemic, such as masks, face shields, desk shields, nasal testing swabs. In many cases, 3D printing is involved.
COVID-19 work highlighted on HSR&D site
For a concise overview of current VA Health Services Research and Development (HSR&D) efforts on COVID-19, visit COVID-19 Efforts.
To rapidly stand up new research and optimize resources during the COVID-19 pandemic, the VA Office of Research and Development (ORD) has coordinated with the National Institutes of Health, the Department of Defense, the Department of Energy, other federal agencies, and several industry partners—namely, pharmaceutical companies. Further, as part of the larger Veterans Health Administration system, ORD has supported other VHA offices by providing research expertise and personnel to assist with public health and informational demands.
Prior to the pandemic, ORD had been pursuing three strategic priorities: enhancing Veteran access to clinical trials; putting VA data to work for Veterans; and increasing the real-world impact of VA research. These priorities continue to guide ORD’s efforts and have positioned the program to quickly respond to COVID-19 through the creation and expansion of research partnerships; optimization of resource allocation; and streamlining and modernization of processes and policies. Part of this effort has involved creating new ways to rapidly support VA investigators eligible for VA research funding, and quickly evaluating research ideas proposed by VA scientists.
Contributing to understanding COVID-19 and potential treatments
ORD is engaged in a wide array of research activities on COVID-19, with the support and cooperation of many internal VA and external partners. These activities encompass a range of studies, as well as innovative approaches to planning, coordinating, and expediting research:
- Working with industry partners to include VA sites in clinical trials for new treatments. In one case, through a coordinated effort, VA was able to get a trial started in under a week—a dramatic reduction over the usual timeframe.
- Coordinating with other federal agencies on national-scale studies on understanding the natural history of and treatments for COVID-19 or specimen collections from patients with COVID-19, to aid in vaccine and therapeutics development.
- Facilitating expanded access (a.k.a. compassionate use) of investigational medications pending FDA approval. Efforts have included establishing a regulatory and pharmaceutical support team consisting of more than 80 VA research field staff for helping facilities obtain approvals for use of these medications.
- Creating opportunities to rapidly fund VA investigators with meritorious research proposals on COVID-19.
- Quickly evaluating research ideas proposed by VA scientists, in large part through a steering committee composed of leading VA experts in virology, infectious disease, and epidemiology.
- Using data and informatics expertise to create common elements for harmonizing research and examining off-label use of approved medications.
- Rapidly synthesizing evidence from the available scientific literature, and translating this evidence into usable guidance for clinicians in VA and beyond.
- Coordinating the establishment of a central VA COVID-19 registry and biorepository.
Ensuring the safety and well-being of research personnel and study participants
To help prevent the spread of COVID-19, reduce exposures among both research staff and patients, and decrease the burden on the health care system, ORD instituted an administrative hold that stopped non-critical, in-person research contacts for all VA-funded research. (Some of this activity has begun to resume as of June, depending on local conditions.) Additional guidance was issued to ensure the safety and protection of all those involved in research. To ensure communication and understanding, ORD has developed a common communication platform for providing written guidance and sharing resources and tools, issued FAQs for field staff, and conducted a series of informational webinars for VA research personnel.
Enabling continuity of operations
As protective measures were implemented for personnel, ORD recognized the importance of continuing research when possible, given the public investments made to date. In this context, regulatory guidance was issued on options and requirements for conducting research through alternative methods. Additionally, ORD worked with the VA Office of Information Technology to issue guidance on the use of communication technologies for research purposes. A field operations workgroup was also set up to examine ongoing research challenges and to develop more uniform guidance for all research programs.