The US Department of Veterans Affairs Science and Health Initiative to Combat Infectious and Emerging Life-Threatening Diseases (VA SHIELD): A Biorepository Addressing National Health Threats

Abstract

Background The SARS-CoV-2 pandemic, caused by the coronavirus disease 2019 (COVID-19), has demonstrated the need to share data and biospecimens broadly to optimize clinical outcomes for US military Veterans. Methods In response, the Veterans Health Administration (VHA) established VA SHIELD (Science and Health Initiative to Combat Infectious and Emerging Life-threatening Diseases), a comprehensive biorepository of specimens and clinical data from affected Veterans to advance research, public health surveillance, and improve diagnostic and therapeutic capabilities. Results VA SHIELD now comprises 12 sites collecting de-identified biospecimens from US Veterans affected by SARS-CoV-2. In addition, two biorepository sites, a data processing center, and a coordinating center have been established under the direction of the VA Office of Research and Development. Phase 1 of VA SHIELD comprises 34,157 samples. Of these, 83.8% had positive tests for SARS-CoV-2, with the remainder serving as contemporaneous controls. The samples include nasopharyngeal swabs (57.9%), plasma (27.9%), and sera (12.5%). The associated clinical and demographic information available permits the evaluation of biological data in the context of patient demographics, clinical experience and management, vaccinations, and comorbidities. Conclusions VA SHIELD is representative of US national diversity with a significant potential to impact national healthcare. VA SHIELD will support future projects designed to better understand SARS-CoV-2 and other emergent health care crises. To the extent possible, VA SHIELD will facilitate the discovery of diagnostics and therapeutics intended to diminish COVID-19 morbidity and mortality and to reduce the impact of new emerging threats to the health of US Veterans and populations worldwide.

VA SHIELD: A Biorepository for Veterans and the Nation

“…The charge and scope of VA SHIELD is unique. 3 As an entity, this program leverages the strengths of the diverse VHA network, has a broad potential impact on national health care, is positioned to respond rapidly to national and international health-related events, and substantially contributes to clinical research and development. In addition, VA SHIELD upholds VA's Fourth Mission, which is to contribute to national emergencies and support emergency management, public health, safety, and homeland security efforts.…”

“…These samples currently account for the majority of biological material within VA SHIELD via a novel collection protocol known as "Sweep," which allows residual clinical discarded samples as well as samples from patients with new emerging infectious and noninfectious diseases of concern to be collected at the time of first emergence and submitted to VA SHIELD during the course of routine veteran health care. 3 These clinical discarded samples are de-identified and transferred from the clinical laboratory to VA SHIELD. The VA Central Institutional Review Board (cIRB) has approved the use of these samples as nonhuman subject research.…”

Hospitalized COVID‐19 patients with diabetes have an increased risk for pneumonia, intensive care unit requirement, intubation, and death: A cross‐sectional cohort study in Mexico in 2020

“…Most COVID‐19 infected individuals recover without the need for specialized medical care, and many do not exhibit any symptoms 7,8 . The severity of the disease is modulated by coexisting medical disorders 9,10 . Pneumonia or respiratory failure are common complications in COVID‐19 cases and can be deadly 11‐14 …”

“…7,8 The severity of the disease is modulated by coexisting medical disorders. 9,10 Pneumonia or respiratory failure are common complications in COVID-19 cases and can be deadly. [11][12][13][14] The chance of developing a severe disease from COVID-19 can rise with age and certain preexisting medical conditions.…”

“… 7 , 8 The severity of the disease is modulated by coexisting medical disorders. 9 , 10 Pneumonia or respiratory failure are common complications in COVID‐19 cases and can be deadly. 11 , 12 , 13 , 14 …”