COVID-19

In response to the COVID-19 pandemic, IHR researchers launched a number of studies to examine the impact of COVID-19 on health care delivery. Studies included treatment trials for investigational medications as well as the impact of more commonly used medications on COVID outcomes. Several studies invested in data infrastructure to support COVID-19 post-illness surveillance and post-vaccine outcomes. Prospective cohorts of patients have been recruited to assess serology testing. In addition, surveys asking patients about their experience with COVID-19 illness have been collected and the increased used of telehealth for care delivery precipitated by the COVID-19 pandemic are being evaluated. Further details about the portfolio of research addressing all aspects of the COVID-19 pandemic are listed below.


COVID-19 Researchers


Featured Projects

Investigator: Rebecca S. Boxer, MD, MS
The NCCAPS study aims to describe cancer treatment modifications made in response to COVID-19 in adult patients and characterize patient factors (pre-existing comorbidities, cancer type and treatment, and demographic factors) associated with short- and long-term outcomes of COVID-19. Study visits are conducted in tandem with existing clinic visits, and we utilize a remote (phone) consent process while patients are completing home isolation periods after COVID-19 diagnosis.
Funder: National Cancer Institute
Study End Date: Currently Open
Investigators: Ingrid A. Binswanger, MD, MPH, MS and Jason Glanz, PhD
The objective of this study is to examine the association between SARS-CoV-2 serology results and late complications of COVID-19 infection. The study will focus on chronic post-acute sequelae COVID-19 (PASC): symptoms persisting, returning, or arising 12 weeks after COVID-19 infection. Understanding this relationship could help determine the role of SARS-CoV-2 serology in clinical practice and public health, such as whether routine screening is warranted. The study will include collecting self-reported data on PASC symptoms in several KP regions through a one-time survey to individuals who have received a SARS-CoV-2 antibody test. The resultant data will be linked to electronic health record (EHR) data on demographics, diagnoses, laboratory data, and utilization.
Funder: Garfield Memorial Fund
Study End Date: 02/28/2023
Investigators: Matthew F. Daley, MD and Jason Glanz, PhD
The Vaccine Safety Datalink uses electronic health record data to study the safety of all currently authorized COVID-19 vaccine in all indicated populations. These studies are conducted in near-real-time, using sophisticated analytic techniques. Any statistical safety signals undergo additional rigorous assessments, including manual review of electronic health record data, to confirm vaccination and case status.
Funder: Centers for Disease Control and Prevention (CDC)
Study End Date: 09/29/2022
Investigators: Jason Glanz, PhD and Matthew F. Daley, MD
The objective of this supplement to the Vaccine Safety Datalink project is to assess knowledge, attitudes, and beliefs regarding COVID-19 vaccines among the general population and pregnant women.
Funder: Centers for Disease Control and Prevention (CDC)
Study End Date: 09/29/2022
Investigators: Matthew F. Daley, MD and Jason Glanz, PhD
The objective of this supplement is to provide additional resources to study the safety of all currently authorized COVID-19 vaccine in all indicated populations. These resources will be used, for example, to perform manual review of electronic health record data, to confirm vaccination and case status.
Funder: Centers for Disease Control and Prevention (CDC)
Study End Date: 09/29/2022
Investigators: Ingrid A. Binswanger, MD, MPH, MS and Jason Glanz, PhD
This research-operations partnership strategy will serve a dual purpose – to ethically outreach members to facilitate testing with careful messaging about the known and unknown implications of serology (including potential harms) and to generate timely data to better understand the implications of positive antibody tests to this novel pathogen. The study will evaluate SARS-CoV-2 IgG antibody results over time among individuals with evidence of prior infection, and correlate with risk of recurrent infection. KPCO members who have and have not had prior infection will be enrolled into a cohort study, complete serial surveys for new COVID-19 symptoms, and serial viral and antibody testing.
Funder: Garfield Memorial Fund and Kaiser Permanente Colorado Health Plan/CPMG
Study End Date: 01/31/2022
Investigator: Claudia A. Steiner, MD, MPH
Sentinel is working with a select number of Data Partners, both claims-based and EHR-based, to produce a “freshest feasible” version of the Sentinel Distributed Database, including COVID diagnostic laboratory data, to support COVID-19 public health surveillance. The main differentiating factor between this database and the routine production SDD is the data lag. The freshest feasible data version will include unadjudicated claims data or other sources of less “settled” data than what is available in the production database.
Funder: U.S. Food and Drug Administration (FDA)
Study End Date: 12/31/2021
Investigator: Elizabeth A. Bayliss, MD, MSPH
Our multi-site team is using EHR data to examine risk of COVID-19 infection and severe outcomes in relation to several types of commonly used medications: estrogens and progestins (found in oral contraceptives [OCs] and hormone replacement therapy) and diabetes medications. In addition, we have designed and conducted analyses examining racial and ethnic disparities in risk of COVID-19 infection and severe outcomes.
Funder: Garfield Memorial Fund
Study End Date: 12/31/2021
Investigator: Elizabeth A. Bayliss, MD, MSPH
Our project focuses on predicting risk of COVID infection and assessing impact of pandemic response among a wide range of our members with high medical and social needs. The project will examine the relationship of self-reported social health care barriers with SARS-COV-2 infection by race/ethnicity among insured adults with access to high-quality health care and qualitatively explore the interaction between self-reported social needs and care delivery during the covid pandemic.
Funder: Garfield Memorial Fund
Study End Date: 12/31/2021
Investigator: John F. Steiner, MD, MPH
The purpose of this study is to describe the use of various existing healthcare delivery modalities prior to and during the COVID-19 pandemic in members with a diagnosis of persistent asthma. We sought to describe differences and similarities before (March-September 2019) and during (March-September 2020) COVID-19, in virtual visits, defined as email, chat, telephone, and video visits and in-person clinic visits. We will also assess clinical outcomes through rates of asthma exacerbations, mode of healthcare utilization, and types of asthma medication during the period of interest.
Funder: IMPROVE (The Innovative Methods to Promote Regional Operational Value and Efficiency) Kaiser Permanente Colorado
Study End Date: 12/31/2021
Investigator: Andrea Burnett-Hartman, PhD, MPH
The primary goal of this study is to characterize the physical, mental, and social health consequences of COVID-19 pandemic on cancer survivors and identify populations of cancer survivors that are at highest risk for the impacts of the COVID-19 pandemic. To accomplish this goal, this project leverages the Kaiser Permanente Research Bank (KPRB) which includes a cohort of approximately 17,000 currently enrolled KP members with a history of cancer and over 110,000 members without cancer from 8 US states and the District of Columbia who completed surveys from April 2020 through January 2021 assessing new onset of COVID-19 symptoms, COVID-19 testing and results, and impacts of COVID-19 on healthcare utilization, social distancing practices, behavioral change, physical activity, depression, anxiety, loneliness, financial strain, and food insecurity. This study will inform healthcare delivery that is aimed at meeting the physical, social, and mental health needs of cancer survivors during the COVID-19 pandemic.
Funder: Kaiser Permanente Program Office
Study End Date: 12/31/2021
Investigator: Debra P. Ritzwoller, PhD
Our project extends the existing common data model observation period (2016–2019) to incorporate data from 1/1/2020–6/30/2021. We will examine virtual visit utilization trends, patient selection related to virtual visit use, and variation in ancillary orders and fulfillments for specific conditions during the initial COVID-19 period through June 30, 2021, among Kaiser Permanente members in Colorado, Georgia, and Mid-Atlantic States regions with encounters (both virtual and in-person) in Adult Primary Care and Behavioral Health.
Funder: Kaiser Permanente Program Office
Study End Date: 12/15/2021
Investigator: Heather Spencer Feigelson, PhD, MPH and Andrea Burnett-Hartman, PhD, MPH
COVNET is a NCI led research project with a goal to conduct large genome-wide studies to identify genetic variants associated with susceptibility to severe or fatal COVID-19 disease compared to mild or asymptomatic COVID-19 using a case-case design. All cases will be genotyped on the Illumina GSA v2 array, and a subset of approximately 4,000-5,000 especially informative cases will be selected for whole genome sequencing. An established shared set of phenotype definitions that overlap with the essential elements outlined by the COVID-19 Host Genetics Initiative (https://www.covid19hg.org/) for ease of combining data among groups will be used. Basic phenotypes and covariates of interest include age at diagnosis, sex, height, weight, ancestry, symptoms (i.e., cough, fever, difficulty breathing, fatigue, muscle pain), days reported a cough, days reported a fever, respiratory rate at admission, pneumonia status, septic shock, organ failure, highest level of respiratory support, if ventilator was used (and, for how many days), and information on basic self-reported comorbidities and risk factors (i.e., smoking, use of medications). To date, the KP Research Bank has contributed over 800 cases to this international study.
Funder: National Cancer Institute (NCI) and Kaiser Permanente Research Bank
Study End Date: 12/2021
Investigator: Andrea Burnett-Hartman, PhD, MPH
The primary objective of this project is to understand health outcomes, including pulmonary, cardiovascular, and COVID-related health outcomes, associated with e-cigarette use. To accomplish this objective, we will use survey and electronic medical records data from Kaiser Permanente Research Bank (KPRB), which includes participants from all 8 KP regions. These data present a unique opportunity to assess adverse health effects of e-cigarettes in a diverse population of adults across the United States. Findings from our analyses will inform health care clinicians and patients about the potential complications of e-cigarette use and provide an assessment of whether or not those who use e-cigarettes should be considered a group that is at high risk for severe COVID-19 illness.
Funder: Kaiser Permanente Community Benefit
Study End Date: 11/30/2021
Investigator: Claudia A. Steiner, MD, MPH
Prior research indicates that up to half of patients hospitalized for COVID-19 may develop arterial or venous thromboembolic complications. However, there are major knowledge gaps on incidence, determinants and consequences of these complications. This study aims to determine the 90-day incidence of thromboembolic events, evaluate patient characteristics present at COVID-19 diagnosis and compare the 90-day risk of thromboembolic events between patient diagnosed with COVID-19 and those diagnosed with influenza.
Funder: U.S. Food and Drug Administration (FDA)
Study End Date: 11/2021
Investigators: Rebecca S. Boxer, MD, MS and Kristi Bronkan, PharmD, BCPS
The ACTIV-4B study is an adaptive randomized double-blind placebo-controlled platform trial to compare the effectiveness of anticoagulation with antiplatelet agents and with placebo to prevent thrombotic events in patients diagnosed with COVID-19 who are not admitted to hospital. The study was closed after the sponsor determined that the number of thrombotic events was very low and did not justify any further treatment. Kaiser Permanente Colorado did not enroll any patients on this trial.
Funder: University of Pittsburgh
Study End Date: 06/17/2021
Investigator: Ted E. Palen, PhD, MD, MSPH
Kaiser Permanente Colorado (KPCO) uses a variety of virtual care modalities. These modes started years before the SARS-coV-2 pandemic began. These modalities include; secure e-mail, Chat with a Doc (real-time texting), eVisits (structured algorithms for select conditions), telephone (scheduled and non-scheduled), physician and nurse advice lines, and video visits. In this study we focused on use of Chat with a Doc, eVisits, and Video Visits during the following time-periods: Pre-COVID (2/28/2019 – 2/29/2020) and during-COVID (3/1/2020 – 11/5/2020). We analyzed the patient characteristics for users of virtual care (age, gender, line-of-business, education level, and household income level) and compared these user’s characteristics before and during the COVID pandemic. We also analyzed their use of other health care services (both in-person and other virtual care services) before and during the pandemic.
Funder: Kaiser Permanente Colorado IRA
Study End Date: 12/31/2020
Investigators: Rebecca S. Boxer, MD, MS and Kristi Bronkan, PharmD, BCPS
This was a randomized, double-blind, placebo-controlled, 29-day, multicenter study to assess the efficacy and safety of ruxolitinib + standard-of-care (SoC) therapy, compared with placebo + SoC therapy, in patients aged ≥12 years with COVID-19 disease.
  • Experimental: Ruxolitinib 5 mg tablets twice daily (b.i.d.) for 14 days with possible extension of treatment to 28 days.
  • Placebo Comparator: Matching-image placebo for 14 days with possible extension of treatment to 28 days.
Funder: Novartis Pharmaceuticals / Collaborator: Incyte Corporation
Study End Date: 10/17/2020
Investigator: Rebecca S. Boxer, MD, MS
This is a prospective, observational cohort trial to evaluate safety, clinical outcomes, and SARS-CoV2 antibody responses in patients 18 years of age or older with respiratory symptoms treated with anti-SARS-CoV-2 convalescent plasma. Patients hospitalized in Kaiser Permanente Colorado affiliated hospitals and enrolled in the study were secondarily recruited by Kaiser research staff to collect additional data from the EMR to evaluate outcomes following convalescent plasma treatment.
Funder: University of Colorado Anschutz Medical Campus
Study End Date: 09/01/2020
Investigators: Rebecca S. Boxer, MD, MS and Kristi Bronkan, PharmD, BCPS
The primary objective of this study is to evaluate the efficacy of 2 remdesivir (RDV) regimens with respect to clinical status assessed by a 7-point ordinal scale on Day 14.
  • Part A (Patients who were not mechanically ventilated): Remdesivir, 5 Days. Participants received continued standard of care (SOC) therapy together with RDV 200 mg on Day 1 followed by RDV 100 mg on Days 2-5; Remdesivir, 10 Days. Participants received continued SOC therapy together with RDV 200 mg on Day 1 followed by RDV 100 mg on Days 2-10.
  • Part B (Extension after enrollment to Part A completed) Remdesivir, 5 or 10 Days (Extension). Participants received continued SOC therapy together with RDV 200 mg on Day 1 followed by RDV 100 mg on Days 2-10. Remdesivir 10 days (Mechanically Ventilated) Participants on mechanical ventilation received continued SOC therapy together with RDV 200 mg on Day 1 followed by RDV 100 mg on Days 2-10.
Funder: Gilead Sciences
Study End Date: 06/30/2020
Investigators: Rebecca S. Boxer, MD, MS and Kristi Bronkan, PharmD, BCPS
The primary objective of this study was to evaluate the efficacy of 2 remdesivir (RDV) regimens compared to standard of care (SOC), with respect to clinical status assessed by a 7-point ordinal scale on Day 11.
  • Part A (Patients who were not mechanically ventilated): Remdesivir, 5 Days. Participants received continued standard of care (SOC) therapy together with RDV 200 mg on Day 1 followed by RDV 100 mg on Days 2-5; Remdesivir, 10 Days. Participants received continued SOC therapy together with RDV 200 mg on Day 1 followed by RDV 100 mg on Days 2-10. Active Comparator: Participants received continued SOC therapy.
  • Part B Extension Treatment, Remdesivir 10 Days. Participants received continued standard of care therapy together with RDV 200 mg on Day 1 followed by RDV 100 mg on Days 2-10.
Funder: Gilead Sciences
Study End Date: 06/26/2020