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

COVID-19大流行于2020年3月在美国广泛传播，直接导致 几乎影响了我们国家的每一个人大量的美国人感染了 SARS-CoV-2病毒。感染该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 几个月后被感染。虽然大流行病在某种程度上影响了每个人， 对我们人口中最脆弱的人，包括那些 无家可归无家可归的退伍军人是一个重大的国家问题，这一流行病只会加剧 需要解决这个问题。许多无家可归的退伍军人要么生活在没有庇护的环境中，要么聚集在一起。 这些环境可能限制了他们保持社交距离的能力，使他们面临更大的感染风险。 此外，最近获得住房的人的日常生活和社会生活往往受到干扰， 和家庭网络，这可能已被大流行病恶化。反过来，这可能会进一步 减少了社会融合，增加了心理健康负担。关键的知识差距存在于， 我们不知道感染造成的负面认知和心理健康结果会持续多久， 他们是在那些谁已被感染，或感染如何影响脆弱的退伍军人（为这项建议， 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的影响来解决这些关键的知识空白。 认知功能，心理健康和社会融合，在最近入住的退伍军人与退伍军人没有一个 长期无家可归的历史。在一个探索性的目标，我们将检查是否风险和保护因素， （复原力、应对、不确定性容忍度）和VA服务利用缓冲了感染的负面影响。 在拟议的4年研究中，我们将在四个大都市地区（洛杉矶）招募400名退伍军人。 洛杉矶，休斯顿，奥兰多和西雅图）使用VA数据库来识别那些已经感染的人， 有长期无家可归的历史比赛共分四组，每组100人， 包括感染者与从未感染者以及有或没有长期无家可归史的人。所有 将在18个月期间每两个月对参与者进行一次远程评估。 通过确定COVID感染对脆弱和非脆弱退伍军人的影响，这项研究可以提供 在任何VA数据库或其他研究中均无法获得有价值的信息。VA必须计划并提供 有效的治疗战略，随着大流行病向地方病发展， 相位本研究的结果将有助于指导最终针对的干预和治疗 改善弱势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.