This is study is comprised of three approaches. First, the investigators will conduct aretrospective cohort study to determine factors associated with COVID-19 severity andcomplications and understand COVID-19 outcomes, including all-cause mortality,post-discharge events, and impacts of rehabilitation services (third aim). The second aimis a mixed-method study and follows COVID-19 patients with repeated surveys to determinepatient-reported functional outcomes, health recovery, and rehabilitation needs afterCOVID-19. The investigators will recruit patients and their informal caregivers forinterviews to assess their function and rehabilitation needs.
The long-term consequences of COVID 19 are not well understood, particularly in the
Veteran population. This study will describe and quantify the long-term consequences of
COVID-19, including impairment in physical and psychosocial function and health-related
quality of life. Additionally, it will determine the impact of chronic lung disease (CLD)
and other comorbidities on severity and recovery after COVID-19 infection and the
association of social determinants of health with severity and recovery.
Initially, a retrospective national cohort of VA patients who test positive with SARS2
will be identified. Baseline clinical history will be analyzed with outcomes that include
severity of COVID 19, all-cause mortality, and post-discharge events.
Subsequently, a mixed methods, prospective cohort study will include both qualitative
(interview) and quantitative components (surveys). The investigators will identify
patients with COVID-19 and recruited for qualitative interviews following hospital
discharge or diagnosis. Patient caregivers will also be eligible to participate in study
interviews. Interviews will occur once at various times ranging 2 weeks to 1 year since a
patient's COVID-19 diagnosis. Surveys will be completed at 3 time points, 2-8 weeks after
diagnosis or discharge to home, and then 6 months and 12 months later. Surveys will
include the EQ-5D-5L profile for health-related quality of life, and the WHODAS 2.0 score
for a global assessment of overall physical and psychosocial function. Investigators will
also identify a comparator cohort of patients who have been diagnosed with lower
respiratory tract infection (LRTI) in the setting of a negative COVID-19 test. Surveys
will be administered at the same interval and analysis will determine if COVID-19 has
different and more severe health impacts than other causes of lower respiratory tract
infection.
Inclusion Criteria:
- (Patients in COVID-19 cohort) VA patients diagnosed with COVID-19 through a positive
PCR (Polymerase Chain Reaction) or antigen SARS-CoV-2 test conducted in VA
- (Caregivers) Providing caregiving to VA patients diagnosed with COVID-19
- (Patients in LRTI cohort) VA patients diagnosed with LRTI and tested negative for
COVID-19 (through PCR and/or antigen test)
Exclusion Criteria:
- Cognitive limitations that preclude the ability to communicate and obtain informed
consent
- Language barriers
VA Ann Arbor Healthcare System, Ann Arbor, MI
Ann Arbor, Michigan, United States
VA Puget Sound Health Care System Seattle Division, Seattle, WA
Seattle, Washington, United States
John R Kundzins, BS
(206) 277-1515
John.Kundzins@va.gov
Kristina A Crothers, MD, Principal Investigator
VA Puget Sound Health Care System Seattle Division, Seattle, WA