Back to Top Skip to main content Skip to sub-navigation

USU cohort study investigates COVID-19 impacts on DOD personnel

Military health personnel wearing a mask and a face shield holding up a sign that has the number eighteen on it Navy Hospital Corpsman 3rd Class Charles Cambern holds up a numbered sign as patients circle through to receive the COVID-19 vaccine at Walter Reed National Military Medical Center, in Bethesda, Maryland. WRNMMC is one of 10 DOD sites undertaking the EPICC study to better understand COVID-19 disease. (U.S. Navy photo by Ricardo Reyes)

Recommended Content:

MHS Toolkits and Branding Guidance | Immunizations | COVID-19 Vaccine Efforts | Coronavirus

The Uniformed Services University of the Health Sciences’ Infectious Disease Clinical Research Program is leading a multi-year study to identify risk factors for COVID-19 in the military population, understand the symptoms and disease course, and investigate clinical outcomes.

Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases with Pandemic Potential – or EPICC – study hopes to inform the Military Health System on ways to improve the patient care and treatment, infection, and disease prevention of those with COVID-19. USU is working in partnership with a network of military commands, treatment facilities, and laboratories across the country for EPICC.

Findings from the study “will support further understanding of the impact of SARS-COV-2 infection on active-duty readiness, acute and chronic clinical outcomes, the effectiveness of new treatments and vaccines, and address questions related to the emergence of new variants and their clinical impact,” said Dr. Brian Agan, deputy science director of IDCRP and principal investigator of the study.

The study is also evaluating how long the immune response to the COVID-19 vaccines lasts, breakthrough infections – which happen when a vaccinated individual becomes sick from the same illness the vaccination is designed to prevent – and how they behave over time, and estimating vaccine effectiveness, said Agan, who is also an employee of the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.

Department of Defense service members and MHS beneficiaries of any age with COVID-19-like illness who are admitted to the hospital or treated as outpatients at an EPICC site can join. Likewise, those 18 years or older who have been tested for COVID-19, whether they tested positive or negative, can participate in the online portion of the study, which includes self-collected blood specimens for selected participants.

The protocol was recently updated to also enroll COVID-19 vaccine recipients and will initiate recruitment upon approval, said Navy Capt. (Dr.) Timothy Burgess, program director of IDCRP, who oversees the study. Eligible beneficiaries who are interested in participating in EPICC can submit an online screening form to join.

“In addition, asymptomatic individuals with a high risk of exposure are also eligible for enrollment in EPICC, which includes health care workers and close contacts of cases,” said Burgess. “Particularly, health care workers who have received a COVID-19 vaccination will be an important population for studies to examine vaccine effectiveness and outcomes.”

Data from inpatient, outpatient, and online participants, including their clinical characteristics, comorbidities, the clinical course of their illness, treatment, immunology, and outcomes, is being collected for the study.

“Questionnaires are provided to enrollees to collect information on demographics, symptoms at initial presentation and chronic or persisting symptoms during follow-up, exposure history, and lifestyle factors,” said Burgess. “Clinical and research specimens collected from enrollees are examined using molecular, serological, and other immune assays in collaboration USU and non-USU partner laboratories.”

Initiated in March 2020, EPICC is expected to continue enrolling participants at least through March 2022, or for as long as needed to fill in the knowledge gaps related to this disease, explained Agan.

“Once enrolled, participants are actively followed for one year to fully capture specimens and data including chronic outcomes and sequelae and will be followed for up to four additional years through electronic medical record review,” Agan said.

EPICC is being conducted at 10 military medical treatment facilities throughout the United States:

  • Brooke Army Medical Center in Fort Sam Houston, Texas
  • Carl R. Darnall Army Medical Center in Fort Hood, Texas
  • Fort Belvoir Community Hospital in Fort Belvoir, Virginia
  • Joint Base Lewis-McChord, Washington
  • Naval Medical Center Portsmouth in Portsmouth, Virginia
  • Naval Medical Center San Diego in San Diego, California
  • Tripler Army Medical Center in Honolulu, Hawaii
  • William Beaumont Army Medical Center in El Paso, Texas
  • Womack Army Medical Center in Fort Bragg, North Carolina
  • Walter Reed National Military Medical Center in Bethesda, Maryland

Military health personnel wearing a face mask and shield speaking to a man who is wearing a face mask
Navy Hospital Corpsman 3rd Class Michael A. Torrent conducts a pre-screening questionnaire prior to administering the COVID-19 vaccine as part of Operation Warp Speed at Walter Reed National Military Medical Center. (U.S. Navy photo by Ricardo Reyes)

By the first week of February, more than 1,600 active-duty service members and MHS beneficiaries had enrolled in EPICC, the majority of whom are being treated as outpatients, said Agan. Approximately half of the subjects with confirmed SARS-CoV-2 diagnoses included in EPICC are active-duty service members.

Some interesting observations the researchers found thus far are that the characteristics of hospitalized COVID-19 patients compared to those treated as outpatients has shown a higher proportion of comorbidities, with hypertension, diabetes, and obesity being most prevalent, said Agan. In fact, their findings have begun to identify why obesity is a risk factor for more severe disease.

They were also able to garner valuable insight into the risk of reinfection from a military health care worker enrolled in the study who was reinfected with a symptomatic case of COVID-19. 

“A median time to recovery has been identified as 14 days, with nine lost duty days among active-duty service members,” said Agan. “These findings not only support operational planning, but also provide an important baseline to evaluate the effectiveness of vaccines as uptake widens across the DOD.”

They also found that the antibody levels that cause immunity remain in individuals for more than six months post-infection and that there were no “seroreversions” after six months post-infection. Seroreversion is the loss of serologic reactivity, or the presence of a particular antigen in the blood, whether spontaneous or in response to therapy. 

“With ongoing concerns about the magnitude and duration of immunity post-infection, our findings were both surprising and a relief,” said Burgess.

The researchers hope the information on the effectiveness and safety of the vaccines will alleviate concerns and encourage individuals to be vaccinated. And as the vaccine rollout expands to more recipients, the study will benefit from recruiting participants among the growing population of vaccinated recipients.

“This will enhance our ability to evaluate vaccine effectiveness in the population and if other reports showing high levels of protection are confirmed, our work may help boost confidence among those who are less certain,” said Burgess. “We are excited about the ability of the EPICC study to answer key questions for patients, health care providers, and leadership to guide decisions as we steer through the coming months of this unprecedented and historic pandemic.

You also may be interested in...

Guardsmen Remain Adaptable in Face of Coronavirus

Article
4/9/2020
Image of two soldiers organizing medical supplies

More than 28,000 National Guardsmen are helping to fight the coronavirus across America

Recommended Content:

Coronavirus

Defense Health Official Urges Personnel, Families to Wear Face Masks

Article
4/8/2020
Image of a soldier wearing a face mask

The face-covering mask can be fashioned from simple household items.

Recommended Content:

Coronavirus

Talking to children about COVID-19 helps them feel safe and secure

Article
4/8/2020
mage of a mom and two kids sitting on house steps

USU expert advises tailoring messages for different age groups

Recommended Content:

Coronavirus

Authorization to Employ Military Medical Capabilities to Treat COVID-19 Patients

Publication
4/8/2020

Effective immediately, the Commander, U.S Northern Command, is authorized, as he deems necessary and appropriate, to employ military medical capabilities under his operational control to treat patients who have contracted coronavirus disease 2019 (COVID-19).

Recommended Content:

Coronavirus

Joint Staff Surgeon Praises Americans Stepping Up to Help COVID-19 Victims

Article
4/7/2020
Image of hospital staff holding a meeting

It's about people helping people, flattening the curve, and slowing the spread of the pandemic so hospitals have a bit more time to prepare.

Recommended Content:

Coronavirus

Decision Memorandum on TRICARE Implementation of the "Families First Coronavirus Response Act"

Publication
4/7/2020

The Families First Coronavirus Response Act, Public Law 116-127, Division F, Section 6006(a), limits TRICARE authority to impose copayment or other cost-sharing for novel coronavirus (COVID-19) testing and related provider visits that result in orders for or administration of Food and Drug Administration (FDA) approved, cleared, or authorized diagnostic products. In order for the Defense Health Agency (DHA) to implement, the Assistant Secretary of Defense for Health Affairs (ASD(HA)) must acknowledge the self-executing authority of the statute and direct the Director, DHA, or designee, to issue guidance implementing the statutory provisions.

Recommended Content:

TRICARE Health Program | Coronavirus

New York City emergency room doc joins Air National Guard as flight surgeon

Article
4/6/2020
Image of flight surgeon

Paladino is Associate Professor of Emergency Medicine at SUNY Downstate Medical Center and also at Kings County Hospital Center.

Recommended Content:

Coronavirus | Coronavirus

DoD Guidance on the Use of Cloth Face Coverings

Publication
4/5/2020

Effective immediately, to the extent practical, all individuals on DoD property, installations, and facilities will wear cloth face coverings when they cannot maintain six feet of social distance in public areas or work centers (this does not include in a Service member's or Service family member's personal residence on a military installation).

Recommended Content:

Coronavirus | Public Health

It’s complicated: Our relationship with social media

Article
4/3/2020
Image of soldier lying down, looking at his phone

COVID-related story on perils of social media

Recommended Content:

Coronavirus

250-patient Army field hospital in Seattle expected to open next week

Article
4/3/2020
Image of soldiers unpacking equipment

The field hospital...will relieve some of the burden on local hospitals, allowing them "freedom of maneuver" to better take care of patients who have COVID-19

Recommended Content:

Coronavirus | Public Health

Policy on Accessions and Accessions Training during the COVID-19 Outbreak

Publication
4/3/2020

The Military Departments must seek ways to maximize accessions in a responsible manner to minimize a reduction in military end strength and the potential deterioration of mid-and long-term readiness and capacity.

Recommended Content:

Coronavirus

Navy secretary visits hospital ship Mercy in Port of Los Angeles

Article
4/2/2020
Image of man getting his temperature taken by service member wearing a mask.

Mercy deployed in support of the nation’s COVID-19 response efforts, and will serve as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals.

Recommended Content:

Coronavirus

Transition of Military Medical Treatment Facilities from Military Departments to the Defense Health Agency during the COVID-19 Response

Publication
4/2/2020

The Department's MTF transition plan is conditions-based. While the transition of MTFs to DHA is continuing, the COVID-19 response requirements are impacting DHA's ability to meet all required conditions. The need for the DHA and MILDEPs to refocus efforts away from the transition to support the COVID-19 response led to questions regarding the future of MTF Transition.

Recommended Content:

Coronavirus | Military Health System Transformation

From the front lines to the home front, Military Medicine is always ready

Article
4/1/2020
Army Lt. Gen. Ron Place and two soldiers stand at a table with COVID-19 testing supplies

Military medicine is providing assistance in unprecedented ways

Recommended Content:

Coronavirus

Possible changes at MTF pharmacies in response to COVID-19

Article
3/31/2020
A military pharmacist choosing medication from a shelf

Find out the latest pharmacy policies at MTFs

Recommended Content:

Coronavirus | Public Health | TRICARE Health Program
<< < ... 36 37 38 39 40  ... > >> 
Showing results 586 - 600 Page 40 of 46

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.