The Department of Veterans Affairs (VA) is launching a comprehensive research initiative to better understand and treat the various symptoms of long COVID, according to comments from VA leaders at an April 25 press conference.
One of the greatest challenges of the COVID-19 pandemic was having to elucidate its symptoms, viral pathology, and treatment methods amidst an abrupt and systemically demanding public health crisis. This placed a combined demand on health networks with clinicians needing to uphold intensive programs of emergency care while working to better understand a novel virus.
The persistence of long-term complications from COVID-19 placed a secondary demand upon healthcare networks, with physicians quickly discovering that patients who recovered from even relatively mild infections were developing a host of complex symptoms ranging from respiratory and cardiovascular harm to various forms of cognitive disability.
As a result, there has been a corresponding demand for a deeper understanding of how COVID-19 induces this range of long-term complications, particularly as a foundation for finding how to mitigate and treat its more enduring symptoms.
VA is now mobilizing resources and expertise to launch a substantial research initiative on the causes and pathology of lasting COVID-19 symptoms with the intent of supporting the nationwide pandemic response.
“The work we do at VA and the lessons we learn at VA will inform and improve how the whole country responds to long COVID. In other words, it'll help the nation care for veterans and non-veterans alike,” said VA secretary Denis McDonough at the April 25 press conference.
The VA designed the research initiative to lessen the burden on the American healthcare system, using the findings to better inform the treatment of long COVID in ways that diminish the long-term burden of the pandemic on patients and caregivers.
“VA, as we often have been during the pandemic, is defining the way forward on long COVID for veterans and for others impacted outside of VA," said Dr. Steven Lieberman, VA’s acting undersecretary for health, at the press conference. "While we have learned many things about long COVID, there is still much more that we need to better understand. Researchers worldwide, including at VA, are working to best define long COVID, to understand what causes it, how it impacts the different human body systems and the best treatments for symptom relief. Or even better, find a cure."
These efforts will be especially impactful considering the sheer amount of Americans who have caught COVID-19, with long COVID appearing in at least one in 20 of those who develop noticeable symptoms.
“There is a myriad of symptoms that can be attributed to long COVID such as fatigue, shortness of breath, cardiovascular issues, pain, dizziness, and kidney damage," Lieberman said. "VA has over 623,000 veteran patients diagnosed with COVID 19 Current estimates are that about 4-7% of them have developed some form of long COVID symptoms. This may go even higher as we work to better define long COVID."
VA has already launched a clinical trial and shared information from various long COVID research programs across the enterprise.
“An enterprise-wide long COVID integrated project team has been established and is charged with organizing, supporting, and reporting the progress of development and diffusion of long COVID Clinical guidance and access to care, support, and services for all veterans," Lieberman said. "The membership of the team is comprised of an interdisciplinary team. Many members are facility and [Veterans Integrated Services Network]-based VHA staff, such as clinicians and researchers."
These efforts will build upon previous long COVID research and treatment projects established throughout VA, bringing preexisting knowledge into this more formally integrated program.
“On the clinical front, VA has previously established a multidisciplinary national long COVID community of practice team in the spring of 2021 made up of about 145 physicians nurses, physical therapists, occupational therapists, social workers, researchers and other disciplines," Lieberman said. "Together, this group has been reviewing their knowledge, lessons learned, and emerging best practices to help us to best define emerging clinical guidelines for care, as well as to solve problems faced by long COVID patients in real time."
VA’s increasingly modernized health IT system and its digitized medical records are serving as the backbone of these research projects, allowing clinicians to engage in various forms of causative analysis designed to better understand the pathology of long COVID.
“We have detailed longitudinal medical information on 6 million veterans, over 620,000 of whom have been diagnosed with COVID," said Dr. Elizabeth Brill, VA deputy assistant health secretary for clinical services, at the press conference. "Most importantly, we can compare health outcomes after COVID infection to those of similar patients who have not been infected, something many studies are unable to do. We have already gathered many notable founding findings using our electronic health record data. And we are filling in the picture with studies that include interviews with thousands of veterans, examinations of blood markers, and exploration of the role of genetics in disease severity and outcomes."
VA ultimately aims to integrate these findings within their nationwide COVID practice while sharing findings with non-VA healthcare networks.
“We look forward to establishing a standardized national approach to care across VA in the coming months," Brill said. "That will continue to be updated as we learn more about long COVID. This will benefit veterans as well as the healthcare community more broadly, as we share our knowledge and expertise in a widespread fashion."