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VA Research on COVID-19

COVID-19 FACT SHEET

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Overview

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

News Briefs

Diabetes medication may lower COVID-19 heart and kidney risk
VA St. Louis researchers showed an SGLT2 inhibitor, a medication that lowers the amount of sugar in the blood, may also lower the risk of heart and kidney problems in people with COVID-19. The analysis included more than 100,000 Veterans taking diabetes medication who contracted COVID-19 between 2020 and 2023, over 11,000 of whom were taking an SGLT2 inhibitor. Those taking SGLT2 inhibitors had an 18% reduced risk of a major adverse cardiovascular event such as heart attack or stroke and a 25% reduced risk of a major adverse kidney event, compared to those taking other types of sugar-lowering medications. SGLT2 inhibitors were also linked to lower risk of secondary hospitalization outcomes, anemia, and acute kidney injury. The results suggest SGLT2 inhibitors may be useful to lower COVID-19 risks in people with diabetes. (Communications Medicine, Sept. 11, 2024)

COVID-19 increases Veterans’ risk of financial hardships
A VA study showed Veterans who contracted COVID-19 were at risk for health-related financial hardships 18 months after infection. Compared to uninfected Veterans, those with a history of COVID-19 were at four-times greater risk of severe-to-extreme health-related financial strain, three-times greater risk of taking less medication due to cost, and twice the risk of needing a loved one to take time off work to care for them. Veterans younger than 65 had a greater risk of financial hardship than older Veterans. The findings suggest a need for strategies to address financial problems caused by COVID-19. (BMC Health Services Research, Aug. 19, 2024)

Vaccines lower long COVID risk
VA St. Louis researchers demonstrated vaccination substantially lowered the risk of long COVID. The study included VA medical records of nearly 450,000 Veterans who had COVID-19 between 2020 and 2022, along with 4.7 million Veterans who were not infected during that time. In the COVID group, 3.5% of those who were vaccinated developed long COVID symptoms one year after infection, compared to 7.8% of unvaccinated Veterans. The study also showed the risk of long COVID has declined since the beginning of the pandemic, with the researchers attributing three-quarters of the decline to the availability of vaccines and the remaining quarter to changes in virus strains. (New England Journal of Medicine, Jul. 17, 2024)

Arthritis drug decreases delirium, coma in critically ill COVID-19 patients
A study including a VA Tennessee Valley researcher found the arthritis drug tocilizumab can decrease delirium and coma in critically ill patients with COVID-19. The study included 253 patients with COVID-19 being treated in the ICU, 69 of whom received tocilizumab. The tocilizumab group had a greater number of days without delirium or coma. The drug did not affect mortality, ventilator use, or hospital length of stay. The results indicate tocilizumab could be an effective way to address delirium and comas in severely ill COVID-19 patients. (Scientific Reports, May 23, 2024)

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)

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Selected Studies by VA Researchers

Clinical Trials

Time to sustained recovery among outpatients with COVID-19 receiving montelukast vs placebo: The ACTIV-6 randomized clinical trial . Rothman RL, Stewart TG, Mourad A, Boulware DR, McCarthy MW, Thicklin F et al. Treatment with montelukast did not reduce duration of COVID-19 symptoms. Findings do not support the use of montelukast for the treatment of mild to moderate COVID-19. JAMA Netw Open. 2024 Oct 1;7(10):e2439332.

Acute estradiol and progesterone therapy in hospitalized adults to reduce COVID-19 severity: A randomized control trial . Lovre D, Qadir MM, Bateman K, Saltzman LY, Sherman M, Mauvais-Jarvis F. Short-term estradiol and progesterone treatment in patients hospitalized for COVID-19 decreased biomarkers of inflammation. Sci Rep. 2024 Sep 30;14(1):22732.

Favorable antiviral effect of metformin on SARS-CoV-2 viral load in a randomized, placebo-controlled clinical trial of COVID-19 . Bramante CT, Beckman KB, Mehta T, Karger AB, Odde DJ, Tignanelli CJ, Buse JB et al. Metformin significantly reduced SARS-CoV-2 viral load, which may explain the clinical benefits in this trial. Clin Infect Dis. 2024 Aug 16;79(2):354-363.

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.

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Laboratory Studies

Long COVID elevated MMP-9 and release from microglia by SARS-CoV-2 spike protein . Kempuraj D, Tsilioni I, Aenlle KK, Klimas NG, Theoharides TC. Release of the enzyme MMP-9 from the COVID-19 virus spike protein stimulated by microglia immune cells could contribute to the development of long COVID and may serve as a target for treatment. Transl Neurosci. 2024 Oct 13;15(1)20220352.

Extacellular histones: A unifying mechanism driving platelet-dependent extracellular vesicle release and thrombus formation in COVID-19 . Eustes AS, Ahmed A, Swamy J, Patil G, Jensen M, Wilson KM, Kudchadkar S et al. Extracellular proteins called histones and procoagulant extracellular vesicles drive the prothrombotic state in COVD-19, and histone-targeted therapy may prove beneficial. J Thromb Haemost. 2024 Sep;22(9):2514-2530.

Differentiation of prior SARS-CoV-2 infection and postacute sequelae by standard clinical laboratory measurements in the RECOVER cohort . Erlandson KM, Geng LN, Selvaggi CA, Thaweethai T, Chen P Erdmann NB et al. No evidence was found that any of 25 routine clinical laboratory tests could serve as a clinically useful biomarker for post-acute sequelae of COVID-19. Ann Intern Med. 2024 Sep;177(9):1209-1221.

Evidence from whole genome sequencing of aerosol transmission of SARS-CoV-2 almost 5 hours after hospital turnover . Charness ME, Gupta K, Linsenmeyer K, Strymish J, Madjarov R, Stack G. Airborne SARS-CoV-2 virus may transmit infection for over four hours, even in a hospital setting. Am J Infect Control. 2024 Jul;52(7):849-851.

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.

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Data Analysis/Review

Effects of buprenorphine, methadone, and substance-use on COVID-19 morbidity and mortality . Christian NJ, Zhou X, Radhakrishnan R. Active substance use was associated with increased morbidity in COVID-19 infection. Medication for opioid use disorder was not associated with worse COVID-19 outcomes compared to other opioids. J Addict Med. 2024 Oct 30. Online ahead of print.

Identifying Veterans who benefit from nirmatrelvir-ritonavir: A target trial emulation . Yan L, Bui D, Li Y, Rajeevan N, Rowneki M, Berry Argraves S et al. Nirmatrelvir-ritonavir was effective in reducing 30-day hospitalization and death in older Veterans, those at highest predicted risk for severe outcomes, and immunocompromised groups. Benefit was not observed in younger Veterans or groups at lower predicted risk for hospitalization and death. 2024 Sep 26;79(3):643-651.

Prevalence and risk factors of post-acute sequelae of SARS-CoV-2 (PASC) among Veterans in airborne hazards and open burn pit registry: A prospective, observational, nested study . Phen SM, Jani N, Klein-Adams JC, Ndirangu DS, Rahman A, Falvo MJ. Post-acute sequelae of COVID-19 are common among Veterans enrolled in the Airborne Hazards and Open Burn Pit Registry, but researchers did not observe any unique military risk factors that augmented the risk. BMC Infect Dis. 2024 Aug 21;24(1):846.

Postoperative outcomes associated with the timing of surgery after SARS-CoV-2 infection . Leeds IL, Park LS, Akgun K, Weintrob A, Justice AC, King JT Jr. In a contemporary surgical cohort, patients with prior COVID-19 infection only had increased postoperative mortality or complications when they had surgery within 14 days after the positive test. Ann Surg. 2024 Aug 1;280(2):241-247

Patients taking benralizumab, dupilumab, or mepolizumab have lower postvaccination SARS-CoV-2 immunity . Runnstrom MC, Lamothe PA, Faliti CE, Cheedarla N, Moreno A, Suthar MS, Nahata R et al. Patients taking biologic medications for asthma or dermatitis had weaker immune responses to COVID-19 vaccination. J Allergy Clin Immunol. 2024 Aug;154(2):435-446.

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Other Research

Development and validation of a machine learning COVID-19 Veteran (COVet) deterioration risk score . Govindan S, Spicer A, Bearce M, Schaefer RS, Uhl A, Alterovitz G, Kim MJ et al. Researchers used machine learning methods to develop and validate a highly accurate early warning score in both Veterans and non-Veterans hospitalized with COVID-19. The model could lead to earlier identification and therapy, which may improve outcomes. Crit Care Explor. 2024 Jul 19;6(7):e1116.

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.

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Commentary

Long COVID science, research and policy . Al-Aly Z, Davis H, McCorkell L, Soares L, Wulf-Hanson S, Iwasaki A, Topol EJ. The writers provide a synthesis of the state of scientific evidence on long COVID; assess the impacts of long COVID on human health, health systems, the economy, and global health metrics; and provide a forward-looking research and policy roadmap. Nat Med. 2024 Aug 9. Online ahead of print.

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.

Long COVID-19 and suicide . Sher L. It is vital to educate clinicians that patients with long COIVD may be suicidal and that it is essential to screen patients with long COVID for suicidality. Adv Exp Med Biol. 2024;1458:51-57.

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.

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Active and Recently Completed Research

Clinical trials

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.

Observational studies

  • 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 ServiceClinical 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.



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