The Enduring Effects of COVID-19 Infection on Psychological Factors, Cognition, and Social Integration inRecently Homeless Veterans

2020年3月在美国广泛流行的新冠肺炎疫情直接导致 几乎影响了我们国家的每一个人。异常多的美国人感染了 SARS-CoV-2病毒。感染病毒的长期影响尚不清楚，但很明显 许多感染病毒的人继续表现出严重的认知和心理影响。 在被感染几个月后。虽然大流行在某种程度上影响了每个人，但它可能 不成比例地影响到我们人口中最脆弱的人，包括那些 无家可归。退伍军人无家可归是一个重大的全国性问题，而这场流行病只会加剧 需要解决这个问题。许多无家可归的退伍军人要么生活在无人庇护的环境中，要么聚集在一起 环境可能限制了他们与社会距离的能力，使他们面临更高的感染风险。 此外，最近获得住房的人经常面临日常生活和社交活动的中断 以及家庭网络，这可能因大流行而加剧。反过来，这可能会进一步 减少社会融合，导致心理健康负担加重。关键的知识缺口存在于 我们不知道感染造成的负面认知和心理健康后果会持续多久，有多普遍 他们是在那些已经被感染的人身上，或者感染如何影响脆弱的退伍军人(对于本提案， 有长期无家可归史的退伍军人)。 这项研究提案将通过检查感染对人类健康的影响来解决这些关键的知识差距 新近入住的退伍军人与没有住房的退伍军人的认知功能、心理健康和社会融合 长期无家可归的病史。在探索性目标中，我们将检查风险和保护因素 (恢复力、应对能力、对不确定性的容忍)和退伍军人管理局服务利用率缓冲了感染的负面影响。 在拟议的为期4年的研究中，我们将在四个大城市地区(洛杉矶)招募总共400名退伍军人 洛杉矶、休斯顿、奥兰多和西雅图)使用退伍军人管理局数据库来识别那些已经感染和 有长期无家可归的历史。共设四个小组，每组100人， 由感染者和从未感染者以及有或没有慢性无家可归史的人组成。全 参与者将在18个月内每2个月远程接受一次评估。 通过确定COVID感染对易感和非易感退伍军人的影响，这项研究可以提供 任何退伍军人事务部数据库或其他研究中都没有的有价值的信息。退伍军人管理局必须计划并提供 随着大流行进入地方性流行，有效的治疗战略来对抗感染的长期影响 相位。这项研究的结果将有助于指导干预和治疗，最终目的是 改善易受伤害的退伍军人和可能感染COVID的退伍军人的社区融合- 19在未来几年。

The COVID-19 Pandemic, which became widespread in the United States in March 2020, has directly impacted nearly everyone in our country. An exceptionally large number of Americans have contracted the SARS-CoV-2 virus. The long-term effects of being infected by the virus are unknown, but it is evident that many of those who contracted the virus are continuing to exhibit severe cognitive and psychological impacts months after becoming infected. While the pandemic has affected everyone in some way, it may have disproportionately impacted those who are the most vulnerable of our population, including those who are homeless. Homelessness in Veterans is a major national issue, and the pandemic has only heightened the need to address the issue. Many homeless Veterans either lived in unsheltered environments or in congregate settings that may have limited their ability to socially distance, putting them at increased risk for infection. Furthermore, those who have recently obtained housing often face a disruption in their daily routines and social and family networks, which may have been exacerbated by the pandemic. This, in turn, could have further reduced social integration and resulted in increased mental health burden. Critical knowledge gaps exist in that we do not know how long negative cognitive and mental health outcomes from infection last, how pervasive they are in those who have been infected, or how infection affects vulnerable Veterans (for this proposal, Veterans with a history of chronic homelessness). This research proposal will address these crucial knowledge gaps by examining the effects of infection on cognitive functioning, mental health, and social integration in recently housed Veterans vs. Veterans without a history of chronic homelessness. In an exploratory aim, we will examine if risk and protective factors (resilience, coping, tolerance of uncertainty) and VA service utilization buffered the negative effects of infection. In the proposed 4-year study we will recruit a total of 400 Veterans across four large metropolitan areas (Los Angeles, Houston, Orlando, and Seattle) using VA databases to identify those who have been infected and have a history of chronic homelessness. There will be four groups in total, with 100 participants in each group, consisting of those infected vs. never infected and those with or without a history of chronic homelessness. All participants will be assessed remotely every 2 months over an 18-month period. By identifying the impact of COVID infection on vulnerable and non-vulnerable Veterans, this study can provide valuable information not available in any VA database or other study. The VA must plan for and provide effective treatment strategies to combat long-term effects of infection as the pandemic moves into the endemic phase. The results from this study will help guide interventions and treatments that ultimately are aimed at improving community integration in vulnerable Veterans and Veterans who may become infected with COVID- 19 in the coming years.