Skip to main content

Military Health System

USU cohort study investigates COVID-19 impacts on DOD personnel

Image of Military health personnel wearing a mask and a face shield holding up a sign that has the number eighteen on it . Military health personnel wearing a mask and a face shield holding up a sign that has the number eighteen on it

Recommended Content:

Immunizations | COVID-19 Vaccine Efforts | Coronavirus & the MHS Response

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...

USAMRIID Focuses on Genome Sequencing to Detect Variants

Article
1/5/2023
Military medical personnel in laboratory

A connected family of laboratories across the MHS allows a more rapid response to the outbreak.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

Whole Genome Sequencing at Tripler Army Medical Center

Article
12/29/2022
Dr. Keith Fong reviews data with other lab technicians

The third installment in a 6-part series highlighting the efforts of the Military Health System laboratories and the technicians who worked to identify COVID-19 variants using special sequencing technology.

Recommended Content:

Coronavirus & the MHS Response | Research & Innovation | Coronavirus

Walter Reed Army Institute of Research Implements SARS-CoV-2 Genome Sequencing

Article
12/23/2022
Military medical personnel in laboratory

This is the second article in a 6-part series that highlights the work of technicians and scientists in Military Health System laboratories who worked to identify COVID-19 variants using special sequencing technology.

Recommended Content:

Global Health Engagement | Coronavirus & the MHS Response | Research & Innovation

Military Labs Use Whole Genome Sequencing of COVID-19 Variants

Article
12/16/2022
Lab technician at work

The first in a 6-part series highlighting the work of technicians and scientists working in support of the MHS who identified COVID-19 variants using special sequencing technology.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

DOD Reduces Health Care Waste by Reusing Crutches

Article
12/15/2022
Military personnel using crutches

When military facilities faced a national shortage of an essential mobility aid, they launched a grassroots initiative that not only ensured patient care, but also created a new waste reduction model within the DHA.

Recommended Content:

Warrior Care | Coronavirus & the MHS Response

Flu Season’s Here: You Still Can Get Your Flu Shot for Protection

Article
12/12/2022
Flu Week Infographic

It’s not too late to get vaccinated against the flu and COVID-19.

Recommended Content:

Immunization Healthcare Division | Immunization Tool Kit | Vaccine Recommendations | COVID-19 Vaccine Efforts | National Immunization Awareness Month 2022 | Immunizations | Winter Safety

Time to Get Your Flu Shot and Your COVID-19 Booster, Too

Article
10/14/2022
Senior MHS officials and medics from the Pentagon stand together Oct. 13 after receiving their flu shots and bivalent COVID-19 boosters.."

It's flu shot time. Get your COVID-19 booster at the same time.

Recommended Content:

Coronavirus & the MHS Response | COVID-19 Vaccine Efforts | Coronavirus and the COVID-19 Vaccine | Seasonal Influenza Vaccine Toolkit | Immunizations | Coronavirus

Prevent the Spread of Influenza and COVID-19 Viruses Within Your Community

Article
10/11/2022
A person getting an injection on their arm.

As families return from summer vacation and students return to school, the influenza (flu) season is approaching while the COVID-19 pandemic is still on-going.

Recommended Content:

Coronavirus & the MHS Response | COVID-19 Vaccine Efforts | Immunizations | Coronavirus and the COVID-19 Vaccine | Seasonal Influenza Vaccine Toolkit

Novavax COVID-19 Vaccine Now Available for 12 to 17 Year-Olds

Article
8/30/2022
Air Force Staff. Sgt. fills a syringe with a COVID-19 vaccine at Ramstein Air Base, Germany.

Novavax COVID-19 Vaccine is Available for Those 12 Years' Old and Above

Recommended Content:

Coronavirus and the COVID-19 Vaccine | COVID-19 Vaccine Efforts

New COVID-19 Boosters Against Subvariants Coming Soon

Article
8/29/2022
Marine on right gets a COVID-19 booster vaccination from a nursing student on his left.

Brooklyn Marine gets COVID-19 booster vaccination.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | COVID-19 Vaccine Efforts

Learn the Most Recent Age Requirements for COVID-19 Vaccines and Boosters

Article
8/10/2022
A man fist bumps a child.

The best way to prevent the spread of COVID-19 is to get your vaccines and booster shots.

Recommended Content:

Coronavirus & the MHS Response | COVID-19 Vaccine Efforts

Telemedicine Privilege by Proxy Expands Access to MHS Care

Article
8/10/2022
Infographic featuring Lt Col Legault

MHS has Telemedicine Privilege by Proxy: A fast, efficient process that enables providers to file one application and get permission to virtually treat patients anywhere in the MHS.

Recommended Content:

Coronavirus & the MHS Response | Telehealth Program

Future of Nursing: Telehealth, More Innovation and Maybe Some Robots

Article
5/13/2022
Second Lt. Nina Hoskins, 81st Surgical Operations Squadron operating room nurse, briefs Col. Debra Lovette, 81st Training Wing commander, and other base leadership on robotics surgery capabilities inside the robotics surgery clinic at the Keesler Medical Center June 16, 2017. (Photo: Kemberly Groue, U.S. Air Force)

The future of nursing is here due in part to changes brought by the COVID-19 pandemic.

Recommended Content:

Nursing in the Military Health System | Coronavirus & the MHS Response

‘I Love the Intensity’ – One Nurse Recalls Three COVID-19 Deployments

Article
5/5/2022
In 2020, Air Force 1st Lt. Tiffany Parra, an ICU nurse at the 633rd Medical Group, on Joint Base Langley-Eustis, Virginia, was deployed to a North Dakota hospital to support a FEMA COVID-19 mission. In the photo, she trains on equipment used for critical patients in a North Dakota ICU. (Photo: Courtesy of Air Force 1st Lt. Tiffany Parra)

Nurses are unique, they follow a calling to care for others. Military nurses do that as well as serve their nation. For Nurses Week, the MHS highlights some of their own.

Recommended Content:

Nursing in the Military Health System | Coronavirus & the MHS Response

How One Military Nurse Persevered Through the COVID-19 Response

Article
5/5/2022
Air Force Capt. Courtney Ebeling, a medical-surgical nurse at Joint Base San Antonio-Randolph Family Health Clinic, Texas, was deployed to support the COVID-19 response in Afghanistan in 2021. They administered vaccinations to U.S. citizens, service members, and foreign military members as well as supported the preparation to withdraw from the country. (Photo: Courtesy of Air Force Capt. Courtney Ebeling)

Nurses across the Military Health System have played a vital role in providing routine patient care and meeting the needs of the COVID-19 pandemic.

Recommended Content:

Coronavirus & the MHS Response | Nursing in the Military Health System
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 14
Refine your search
Last Updated: December 28, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery