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Principal Investigator: TARA AUSTIN
Organization: VA SAN DIEGO HEALTHCARE SYSTEM
Fiscal Year: 2024
Funding agency: Veterans Affairs
2-8% of the US population report “long COVID” symptoms – including “brain fog,” thinking difficulties, memory
problems, and psychiatric symptoms such as sleep disturbance, anxiety, and depression. Rates of post-
COVID-19 symptoms are nearly double in the Veteran population. These cognitive symptoms contribute to
functional impairments, reduced quality of life, poorer self-reported health status, psychological distress,
delayed return to work, new onset disability, reduced community integration, and increased healthcare
utilization. One promising treatment to improve both everyday functioning and cognition secondary to post-
COVID-19 symptoms is Compensatory Cognitive Training (CCT). Previous studies have found that CCT is
feasible, acceptable, and efficacious in Veteran populations with multiple sources of cognitive dysfunction. The
proposed CDA provides a golden opportunity to evaluate CCT for Veterans with prolonged COVID-19
symptoms (CCT-C), compared with a robust control condition, Holistic Cognitive Education (HCE). The project
closely aligns with current RR&D priorities, by “examining COVID-19-specific rehabilitation interventions and
responses to treatment” and by addressing “late or delayed effects of secondary conditions related to COVID-
19 infections on impairment and disability.” Specific aims are 1) to conduct a pilot randomized controlled trial of
remote CCT-C with 70 Veterans (35 CCT-C, 35 HCE) with post-COVID-19 cognitive symptoms to examine
feasibility, acceptability, and initial efficacy; 2) to examine the preliminary efficacy of CCT-C in this population
on overall functioning, as measured by the World Health Organization’s Disability Assessment Schedule
(WHODAS 2.0), performance-based measures of functional capacity, and secondary outcomes (cognitive
performance, quality of life, self-reported cognitive problems, psychiatric symptoms, sleep disturbance, and
engagement in work/community activities); and 3) to explore moderators of outcome (e.g., age, initial COVID-
19 severity, baseline cognitive functioning, presence of PTSD/mTBI history; biomarkers related to COVID-19
infection). The candidate, Dr. Tara Austin, is currently a Postdoctoral Fellow at the VA San Diego Healthcare
System. The overarching objective of Dr. Austin’s Career Development Award–2 (CDA-2) research plan is to
build on her previous clinical and research experience in interventional neuropsychology and establish her
research career focused on cognitive rehabilitation treatments for Veterans. Specifically, her training plan has
been designed to develop expertise in adapting cognitive rehabilitation treatments for novel populations
exposed to a range of chemical, physical, environmental, and infectious hazards, including exposure to novel
infectious diseases, such as COVID-19. Her proposed training includes training in cognitive rehabilitation (Dr.
Twamley), clinical trial methodology (Drs. Twamley and Thomas), cognitive and functional outcomes (Drs.
Twamley, Ford, and Wynn), biomarkers associated with neuroinflammation (Drs. Ford and Pulliam), and
advanced statistical techniques (Dr. Thomas). This training will support Dr. Austin’s career as an independent
VA research scientist with expertise in developing and evaluating interventions to improve functioning and
quality of life in Veterans with cognitive symptoms secondary to exposures or illnesses such as COVID-19.
Terms: <Acceleration><Activities of Daily Living><Activities of everyday life><Acute><Address><Adverse effects><Age><Anxiety><Area><Attention><BBB crossing><Biological Markers><Brain><Brain Nervous System><Brain Vascular><COVID disease severity><COVID severity><COVID-19><COVID-19 disease severity><COVID-19 infection><COVID-19 negative><COVID-19 severity><COVID-19 virus infection><COVID19 disease severity><COVID19 infection><COVID19 negative><COVID19 severity><CV-19><Cardiovascular><Cardiovascular Body System><Cardiovascular Organ System><Cardiovascular system><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Chemicals><Chronic Headaches><Chronic Phase><Classification><Clinical><Clinical Trials><Cognition><Cognitive><Cognitive Disturbance><Cognitive Impairment><Cognitive Manifestations><Cognitive Symptoms><Cognitive aging><Cognitive decline><Cognitive function abnormal><Communicable Diseases><Communities><Community Integration><Contracting Opportunities><Contracts><Coronavirus Infectious Disease 2019><Development><Diagnosis><Diagnostic><Disability Assessment><Disability Determination><Disability Evaluation><Disabling><Disease><Disorder><Disturbance in cognition><Education><Educational aspects><Employment><Encephalon><Exposure to><Fatigue><Feedback><Functional impairment><Health Care Systems><Health Care Utilization><Health Status><Health behavior><Healthcare Systems><Heart Vascular><History><Household><Human><Hypoxia><Hypoxic><Immune response><Immunological response><Impaired cognition><Impairment><Infection><Infectious Disease Pathway><Infectious Diseases><Infectious Disorder><Inflammatory><Injury><Intervention><Intervention Strategies><Interview><K-Awards><K-Series Research Career Programs><Lack of Energy><Length><Level of Health><Long COVID><Long COVID-19><Long coronavirus disease><Long coronavirus disease 2019><MTBI><Measures><Mediating><Medical Rehabilitation><Memory><Mental Depression><Mentors><Mentorship><Methodology><Modern Man><Moods><Nerve Cells><Nerve Unit><Neural Cell><Neurobehavioral Manifestations><Neurobehavioral Signs and Symptoms><Neurocyte><Neurons><Neurophysiology - biologic function><Neuropsychologies><Neuropsychology><Outcome><Oxygen Deficiency><PTSD><Participant><Patient Self-Report><Persons><Population><Post-Traumatic Neuroses><Post-Traumatic Stress Disorders><Postdoc><Postdoctoral Fellow><Posttraumatic Neuroses><Protocol><Protocols documentation><Psychometrics><QOL><Quality of life><Randomized, Controlled Trials><Recording of previous events><Rehabilitation><Rehabilitation therapy><Reporting><Research><Research Associate><Research Career Program><Respiratory Signs and Symptoms><Risk><SARS-CoV-2 disease severity><SARS-CoV-2 infection><SARS-CoV-2 negative><SARS-CoV-2 severity><SARS-CoV2 infection><Sampling><Schedule><Scientist><Secondary to><Self-Report><Severe acute respiratory syndrome coronavirus 2 infection><Sleep disturbances><Social Functioning><Source><Structure><Symptoms><Systematics><Techniques><Thinking><Time><Training><Trauma><Veterans><Viral><WHODAS><Work><World Health Organization><World Health Organization Disability Assessment Schedule><aberrant sleep><active control><acute COVID-19><acute SARS-CoV-2 infection><acute phase of COVID-19><acute phase of SARS-CoV-2 infection><after COVID-19 infection><after SARS-CoV-2 infection><after SARS-CoV2 infection><after infection by SARS-CoV-2><after severe acute respiratory distress syndrome CoV-2 infection><ages><airway symptom><analyzing longitudinal><bio-markers><biologic marker><biomarker><blood-brain barrier crossing><bloodbrain barrier crossing><brain fog><career><cerebral vascular><cerebro-vascular><cerebrovascular><chronic COVID><chronic COVID-19><chronic novel coronavirus disease 2019><chronic pain><circulatory system><cognitive change><cognitive dysfunction><cognitive function><cognitive loss><cognitive performance><cognitive rehab><cognitive 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use><healthcare service utilization><healthcare utilization><histories><host response><immune system response><immunoresponse><impaired sleep><improve function><improved><improved functional outcomes><infected with COVID-19><infected with COVID19><infected with SARS-CoV-2><infected with SARS-CoV2><infected with coronavirus disease 2019><infected with severe acute respiratory syndrome coronavirus 2><injuries><interventional strategy><irregular sleep><long haul COVID><long haul COVID-19><long haul coronavirus disease><long haul coronavirus disease 2019><long-hauler COVID><long-hauler COVID-19><long-hauler coronavirus disease 2019><long-hauler syndrome><long-term COVID><long-term COVID-19><long-term coronavirus disease><long-term coronavirus disease 2019><longitudinal analysis><longterm COVID><longterm COVID-19><longterm coronavirus disease><longterm coronavirus disease 2019><mild TBI><mild brain trauma><mild traumatic brain injury><military veteran><neural function><neural inflammation><neurobehavioral symptom><neuroinflammation><neuroinflammatory><neuronal><neuropsychiatric symptom><neuropsychologic><novel><pandemic><pandemic disease><performance based assessments><performance based measurement><performance based measures><persistent COVID-19><post COVID syndrome><post COVID-19 syndrome><post SARS-CoV-2 infection><post acute COVID syndrome><post acute COVID-19><post acute COVID-19 syndrome><post acute SARS-CoV-2><post acute coronavirus disease 2019><post acute coronavirus disease 2019 syndrome><post acute coronavirus disease syndrome><post acute severe acute respiratory syndrome coronavirus 2><post coronavirus disease 2019 syndrome><post coronavirus disease syndrome><post intervention><post-COVID><post-COVID-19><post-acute phases of COVID-19><post-coronavirus disease 2019><post-doc><post-doctoral><post-doctoral trainee><post-trauma stress disorder><posttrauma stress disorder><previous COVID-19 infection><previous SARS-CoV-2 infection><previous SARS-CoV2 infection><previous severe acute respiratory distress syndrome CoV-2 infection><prior COVID-19 infection><prior SARS-CoV-2 infection><prior SARS-CoV2 infection><prior severe acute respiratory distress syndrome CoV-2 infection><prolonged COVID-19 symptoms><psychiatric symptom><psychological distress><psychosocial stresses><psychosocial stressors><randomized control trial><recruit><rehab research><rehab therapy><rehabilitation research><rehabilitative><rehabilitative therapy><remote administration><research associates><respiratory symptom><response to therapy><response to treatment><secondary outcome><severe acute respiratory syndrome coronavirus 2 disease severity><severe acute respiratory syndrome coronavirus 2 negative><severe acute respiratory syndrome coronavirus 2 severity><sleep disruption><sleep dysregulation><social><statistics><telomere><theories><therapeutic response><therapy response><thoughts><traumatic neurosis><treatment response><treatment responsiveness><veteran 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