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.
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)
Paxlovid lowers risk of COVID post-conditions, hospitalization, death
A study by VA St. Louis researchers found that the antiviral drug Paxlovid lowers the risk of long COVID and death. The researchers looked at outcomes of more than 280,000 high-risk VA COVID-19 patients, nearly 36,000 of whom had been prescribed Paxlovid (generic name nirmatrelvir). Patients who were given the medication within five days of a positive COVID-19 test had a 26% lower risk of developing post-COVID conditions, a 47% lower risk of death from the disease, and a 24% lower risk of needing hospitalization. Paxlovid reduced the risk of long COVID symptoms in people who were unvaccinated, vaccinated, and boosted, and in people with their first infection or a reinfection. Study author Dr. Ziyad Al-Aly said the findings support using Paxlovid for high-risk patients both to treat acute COVID-19 and to lower the risk of lasting effects. (JAMA Network Open, March 23, 2023)
VA tablet program increased Veterans’ telehealth use during pandemic
The VA Office of Connected Care widely expanded its video-enabled tablet program at the onset of the pandemic, increasing the number of Veterans who received tablets nearly six-fold. When VA Palo Alto researchers and colleagues compared pandemic access numbers to those from 2019 and 2020, they found that Veterans who received tablets during the pandemic were more likely to use video care, and they did so more frequently than those who received tablets before the pandemic. However, older Veterans, or those unstably housed, were less likely to use video visits than other groups. The researchers concluded interventions may be needed to improve telehealth access for Veterans with unstable housing or who are less familiar with technology. (Journal of Medical Internet Research, Dec. 20, 2022)
View all studies
Selected Studies by VA Researchers
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.
The effect of povidone-iodine nasal spray on nasopharyngeal SARS-Co-V-2 viral load: A randomized control trial. Zarabanda D, Vukkadala N, Phillips KM, Qian ZJ, Mfuh KO, Hatter JN, Lee IT et al. Dilute versions of povidone-iodine nasal spray are safe for topical use in the nasal cavity, but the spray does not demonstrate virus-eliminating activity in COVID-19 positive patients. Laryngoscope. 2022 Nov;132(11):2089-2095.
Efficacy and safety of ensovibep for adults hospitalized with COVID-19: A randomized controlled trial. ACTIV-3/TICO Study Group et al. Compared with placebo, the medication ensovibep did not improve clinical outcomes for hospitalized participants with COVID-19 standard care, including remdesivir. No safety concerns were identified. Ann Intern Med. 2022 Sep;175(9):1266-1274.
Comparison of virus aerosol concentrations across a face shield worn on a healthcare personnel during a simulated patient cough. Pratt AA, Brown GD, Perencevich EN, Diekema DJ, Nonnenmann MW. Face shields reduce virus and particle concentrations. However viable viruses were still measured on the inside of a face shield in the breathing zone of the health care worker during simulated coughing. Other exposure control methods need to be used to prevent transmission from virus aerosol. Infect Control Hosp Epidemiol. 2023 Aug 23;1-6.
Oxylipin concentration shift in exhaled breath condensation (EBC) of SARS-CoV-2 infected patients . Borras E, McCartney MM, Rojas DE, Hicks TL, Tran NK, Tham T, Juarez MM et al. Monitoring exhaled breath concentrations of oxylipin and other compounds presents an interesting opportunity to monitor key indicators of COVID-19 disease progression and severity. J Breath Res. 2023 Aug 7;17(4).
NK cells from COVID-19 positive patients exhibit enhanced cytotoxic activity upon NKG2A and KIR2DL1 blockade. Lee G, Schauner R, Burke J, Borocz J, Vasana S, Sobieraj L, Giraudo M et al. This study reveals new insights into Natural Killer cell phenotypes during SARS-CoV-2 infection and suggests a therapeutic approach worthy of further investigation to enhance NK cell-mediated responses against the virus. Front Immunol. 2023 Jul 7;14:1022890.
Vascular and non-HLA autoantibody profiles in hospitalized patients with COVID-19. Lichtenstein B, Zheng Y, Gjertson D, Ferbas KG, Rimoin AW, Yang OO, Aldrovandi GM et al. Patients hospitalized with COVID-19 demonstrate evidence of auto-reactive antibodies targeting endothelial cells, angiotensin II receptors, and numerous structural proteins including collagens. Front Immunol. 2023 Jun 15;14:1197326.
Honokiol inhibits SARS-CoV-2 replication in cell culture at a post-entry step . Salago-Benvindo C, Leijs AA, Thaler M, Tas A, Arbiser JL, Snijder EJ, van Hemert MJ. Honokiol, a molecule from the magnolia tree, inhibits replication of the virus that causes COVID-19. Microbiol Spectr. 2023 May 22. Online ahead of print.
Frailty as a risk factor for post-acute sequelae of COVID-19 among US veterans during the Delta and Omicron waves . Hammel IS, Tosi DM, Tang F, Pott H, Ruiz JG. Frailty was associated with an increased risk of developing post-acute sequelae of COVID-19 infection. Vaccination was associated with a decreased risk of sequelae, further reduced by booster doses. J Am Geriatr Soc. 2023 Sep 19. Online ahead of print.
Vaccination status and trends in adult coronavirus disease 2019-associated hospitalizations by race and ethnicity: March 2020-August 2022 . Ko JY, Pham H, Anglin O, Chai SJ, Alden NB, Meek J, Anderson EJ et al. Race/ethnicity disparities in COVID-19-associated hospitalizations declined but persisted in the era of vaccination. Clin Infect Dis. 2023 Sep 18;77(6):827-838.
Nirmatrelvir/ritonavir use and hospitalizations or death in previously uninfected non-hospitalized high-risk population with COVID-19: A matched cohort study . Butt AA, Yan P, Shaikh OS, Talisa VB, Omer SB, Mayr FB. Nirmatrelvir/ritonavir is associated with a significant reduction in 30-day hospitalization or death among previously uninfected, non-hospitalized individuals. J Infect Dis. 2023 Sep 15. Online ahead of print.
Growing deficit in new cancer diagnoses 2 years into the COVID-19 pandemic: A national multicenter study . Englum BR, Sahoo S, Mayorga-Carlin M, Hayssen H, Siddiqui T, Turner DJ, Sorkin JD, Lal BK. Disruptions in new diagnoses of four common cancers (prostate, lung, bladder, and colorectal) seen early in the COVID-19 pandemic have persisted for two years. Ann Surg Oncol. 2023 Sep 11. Online ahead of print.
Characteristics and outcomes of US Veterans with immunocompromised conditions at high risk of severe SARS-CoV-2 infection with or without receipt of oral antiviral agents. Gentry CA, Nguyen PN, Thind SK, Kurdgelashvili G, Williams RJ. Use of molnupiravir or nirmatrelvir-ritonavir was associated with lower incidence of hospitalization or death within 30 days of diagnosis in Veterans with immunocompromised conditions, regardless of vaccination status. Clin Infect Dis. 2023 Aug 24. Online ahead of print.
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.
Loss during COVID-19: Moderating effects of meaning and romantic relationships on anxiety and depressive symptoms . Gold AI, Ryjova Y, Corner GW, Rasmussen HF, Kim Y, Margolin G. Cumulative pandemic-related loss is associated with anxiety and depressive symptoms, and meaning in life and romantic relationships may be promising interventional targets. Psychol Trauma. 2023 Jul 31. Online ahead of print.
Pandemic-related posttraumatic psychological growth in U.S. military Veterans: A 3-year, nationally representative, longitudinal study. Kang H, Na PJ, Fischer IC, Tsai J, Tedeschi RG, Pietrzak RH. Results suggest that psychosocial interventions to bolster posttraumatic growth in relation to early life traumas may help facilitate posttraumatic growth in response to the pandemic and related crises. Psychiatry Res. 2023 Jul 24. Online ahead of print.
COVID-19-related media consumption and posttraumatic stress symptoms in U.S. military Veterans: A nationally representative, longitudinal study. Whealin JM, Fischer IC, Na PJ, Pietrzak RH. COVID-19 media consumption is independently linked to a greater likelihood of pandemic-related posttraumatic stress symptoms in Veterans. Psychiatry Res. 2023 July 18;326:115354.
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.
Leveraging anthropological expertise to respond to the COVID-19 global mental health syndemic. Azevedo KJ, Riendeau RP, Sweet PA, Holmes SM. Anthropologists collaborating directly with mental health clinicians and the public can contribute to solutions to improve mental health issues exacerbated by the COVID-19 pandemic. Am Anthropol. 2022 Jun. Online ahead of press.
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.
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.