September 2020

In This Issue: How Research Helps Combat COVID-19
» Table of Contents

Overview: COVID-19

The unprecedented Coronavirus disease 2019 (COVID-19) pandemic has led to a significant shift in U.S. healthcare. Like other health systems, VA is primarily focused on the prevention, containment, and treatment of COVID-19. However, a recent study indicates hypertension, diabetes, and obesity are linked to poorer outcomes among those who contract COVID-19,¹ and these conditions are highly prevalent among Veterans: approximately 68% of Veterans are considered either overweight or obese;² nearly 25% have diabetes;³ and hypertension is the most common chronic condition among Veterans, affecting 37% of VA patients.⁴ This places an additional burden on Veterans and VA.

The pressing need for a rapid scalable response to this highly contagious disease also highlights the important role of implementation strategies in ensuring the widespread, consistent uptake of best practices among frontline providers, who also must treat ongoing chronic conditions. With a flexible structure including implementation and data science expertise, VA HSR&D’s Quality Enhancement Research Initiative (QUERI) Centers are designed to adapt their current implementation efforts and support VA in responding to emerging issues, like COVID-19, using evidence-based practices (EBPs) and collaborative team-based approaches.

This issue of In Progress highlights the following ongoing HSR&D studies that will help VA provide the best healthcare possible during and after this pandemic. There also are other ongoing efforts by HSR&D to further our knowledge in order to combat the COVID-19 pandemic. HSR&D has 20 rapid response projects, including one featured in this issue on telemental healthcare for Veterans with opioid use disorder. Telehealth is of increasing importance during the pandemic. Another example of HSR&D’s work is from its Evidence Synthesis Program (ESP), which is reviewing the literature on hydrogen peroxide as a sterilizing procedure for N95 masks, in response to reports of contact dermatitis being associated with reused masks. In addition, HSR&D investigators are working with operational partners to examine several drugs and COVID-19, such as remdesivir (broad-spectrum antiviral), anticoagulants, steroids, and statins.

1. Richardson S, Hirsch J, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5,700 patients hospitalized with COVID-19 in the New York City area. JAMA. April 22, 2020;323(20):2052-2059.
2. Maciejewski M. Measuring the longitudinal relationships between obesity, weight management intervention, and medical expenditure. HSR&D study IIR 18-019.
3. Prevalence of and trends in diabetes among Veterans, United States, 2005-2014. CDC, Research Brief (14). December 14, 2017.
4. Mohanty A. Race/ethnic differences in guideline recommended hypertension medications in VHA. HSR&D study CDA 18-327.