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News | Oct. 18, 2023

Walter Reed Partners with Uniformed Services University to Treat Long Haul Covid

By James Black, WRNMMC, Office of Command Communications

Three years after COVID-19 claimed more than 1 million lives in the United States, thousands continue to live with the debilitating effects of Long-Haul Covid (LHC), a complex constellation of symptoms that can last for months or years, potentially affecting every major organ system.

That’s why researchers at Walter Reed National Military Medical Center have partnered with the Uniformed Services University’s (USU) F. Edward Hébert School of Medicine to find new therapies to address the harmful effects of LHC, which often include persistent fatigue, shortness of breath, an erratic heart rate, depression, and brain fog.

“My wife and brother-in-law have been devastated by LHC,” confided Dr. Mark C. Haigney, the director of cardiology at USU. “My wife’s major symptom has been fatigue requiring one to three naps per day, while my brother-in-law has been afflicted [with occurrences] of brain fog,” causing moments of confusion or forgetfulness – detrimentally affecting an executive whose reliance on his analytical skills and decision-making prowess are critical to his team’s mission success.

The COVIVA Study: Military Research Implications for Saving and Improving Lives

U.S. Army COL (Dr.) David Saunders, the director of USU’s Translational Medicine Unit, and the multidisciplinary study team are exploring clinical similarities among LHC, postural orthostatic tachycardia syndrome (POTS), and inappropriate sinus tachycardia (IST). Better understanding these conditions will have significant implications for treating fatigue, chest pain, blurred vision, and brain fog in military personnel and returning them to duty.

Earlier this year, Haigney and Saunders initiated the COVIVA study, a clinical trial involving 200 LHC volunteers to discern the effectiveness of Ivabradine, a drug approved by the Food and Drug Administration (FDA) to reduce the likelihood of heart failure in at-risk patients.

“Because of the complexity of LHC and POTS, the study is an opportunity to evaluate new diagnostic technologies,” shared Saunders, who recently served as Medical Director and Product Manager for the U.S. Army’s Medical Materiel Development Activity (USAMMDA).

Volunteers are monitored remotely several times during the study for up to a week while wearing FDA-approved diagnostic sensors to measure critical vital signs and cardiac activity.

Saunders said these medical “devices could be game changers on the battlefield,” allowing the real-time monitoring of soldiers to detect a variety of conditions like sepsis, heat and cold injuries, blood loss and infections.

Haigney and Saunders agree, these technologies could greatly reduce the military medical logistics footprint in contested environments, saving lives by better informing medics to evaluate and treat life-threatening injuries pending evacuation.

Ivabradine: A Potential Drug Therapy for Treating LHC, POTS and IST

Saunders said one of the most important takeaways so far is observing a higher rate of POTS than the team expected. “We designed the study expecting that one in four with LHC would have POTS, but so far, it’s been double that rate.

POTS is one of a group of autonomic nervous system disorders that can occur after viral infections, such as COVID. The autonomic nervous system controls vital functions within the body. Patients with POTS actually have normal hearts but have trouble adjusting their heart rates to an appropriate speed after they stand up. They may have a variety of related disorders ranging from abnormal sweating and urinary incontinence to brain fog, anxiety and depression.

COVIVA Study: The Intersection of Pharmacology and Medical Devices

Since Haigney first proposed the COVIVA study two years ago, the team of investigators, collaborators and research staff has grown to more than 50 participants. Dr. Jessica Wong-Flores, a pharmacist at Walter Reed, plays an invaluable role in meticulously tracking the volunteers using Ivabradine and the placebo drug, shared Haigney.

Saunders commends U.S. Army Maj. Martin Evans, a staff allergist at Walter Reed, for providing valuable insight while honing his skills in conducting regulated clinical trials – continuing an Army and Department of Defense (DoD) tradition of “Forging the Future” by cultivating talent and pursuing novel technologies and therapies.

The Army Wants You to Volunteer: MHS Genesis Registrants or General Public

Saunders and Haigney said they’re still seeking volunteers to fill out the 200-patient roster to discern the effectiveness of Ivabradine in treating LHC. Additionally, they are looking to include another 50 volunteers who had Covid-19 but have no symptoms. So, if you’re between the ages of 18 to 80, have tested positive for Covid-19 and are willing to take part in a yearlong study, there’s still time to register.

For more information, email: clinical.research.unit.53-ggg@usuhs.edu, or call: 301-318-6024.
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