chronic lung disease and covid-19: understanding severity, recovery and rehabilitation needs

Conditions: COVID-19; Chronic Lung Diseases

Summary: this is study is comprised of three approaches. first, the investigators will conduct a retrospective cohort study to determine factors associated with covid-19 severity and complications and understand covid-19 outcomes, including all-cause mortality, post-discharge events, and impacts of rehabilitation services (third aim). the second aim is a mixed-method study and follows covid-19 patients with repeated surveys to determine patient-reported functional outcomes, health recovery, and rehabilitation needs after covid-19. the investigators will recruit patients and their informal caregivers for interviews 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.

Eligibility criteria:
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

Keywords: chronic lung disease covid-19 rehabilitation veterans sars-cov-2 copd