# Chronic Lung Disease and COVID-19: Understanding Severity, Recovery and Rehabilitation Needs (LAUREL Study)

> **NIH VA I01** · VA PUGET SOUND HEALTHCARE SYSTEM · 2021 · —

## Abstract

SARS-CoV-2 (SARS2) infection, which leads to COVID-19, is a global pandemic. Chronic lung disease (CLD),
particularly chronic obstructive pulmonary disease (COPD), has emerged as a risk factor for infection and
severity of COVID-19. Currently, very little is known of the long-term consequences of COVID-19 and how
factors such as CLD, other comorbidities and social determinants of health (SDOH) influence the trajectory of
recovery in survivors. While similar complications for COVID-19 survivors and risk factors for poor health
recovery may be expected as in other causes of pneumonia and critical illness, long term outcomes of COVID-
19 have not been characterized or quantified. Patients who are hospitalized and critically ill are anticipated to
have greater functional deficits, but even those with mild and moderate COVID-19 may have significant
impacts on function given systemic involvement of infection; rehabilitation needs may be more likely to be
under-recognized and unmet in many of these patients. Overall, functional outcomes may be worse than
expected in all COVID-19 patients because of prolonged length of illness and barriers to receiving rehabilitation
services, including restricted face-to-face interactions, limited capacity, and limited access for many. Because
CLD is associated with increased frailty and impaired function, patients with CLD may be particularly
vulnerable not only to infection but also sequalae of COVID-19. Given the current physical distancing
environment, we urgently need a new paradigm for rehabilitation of patients recovering from COVID-19 that
can inform and apply to other causes of pneumonia as well. In this proposal we will determine patient
rehabilitation needs across the spectrum of severity of COVID-19, assessing if needs differ by CLD,
comorbidity burden, SDOH or other patient risk factors. We will also assess the feasibility and acceptability of a
novel, virtually-delivered, home-based personalized telerehabilitation program for survivors of COVID-19 that
contains a COVID Reactivation and Engagement (CORE) intervention with exercise and dyspnea
management and additional personalized modules based on patient needs. We will recruit patients treated for
COVID-19 as outpatients or discharged directly home for this program. We have a multidisciplinary team with
expertise in rehabilitation medicine, psychology, pulmonary, critical care, nursing, complementary and
integrative health, quantitative and qualitative observational research and clinical trials, and will accomplish
three separate aims: 1) Determine patient factors associated with severity and complications of COVID-19
utilizing VA EHR data; 2) Determine self-reported functional outcomes and trajectory of recovery after COVID-
19 in a prospective study using mixed methods; and 3) Examine the feasibility and acceptability of a virtually-
delivered, home-based rehabilitation intervention for survivors of COVID-19, with components based on an
individual patien...

## Key facts

- **NIH application ID:** 10187862
- **Project number:** 1I01RX003666-01
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Kristina Anne Crothers
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-01-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10187862

## Citation

> US National Institutes of Health, RePORTER application 10187862, Chronic Lung Disease and COVID-19: Understanding Severity, Recovery and Rehabilitation Needs (LAUREL Study) (1I01RX003666-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10187862. Licensed CC0.

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