Our findings suggest that the COVID-19 pandemic affected the publication productivity of recipients of NHLBI K01, K08, and K23 awards more in states with a late peak in COVID-19-related deaths. A late peak may be a manifestation of a variety of factors, including pandemic fatigue, vaccine hesitancy or delays, the emergence of novel variants, poor resource allocation or public compliance, or premature relaxation of preventative measures [3]. The observed geographic variability should be considered when implementing measures such as providing supplementary funding and extensions for tenure-track positions to mitigate the impact of the pandemic on early career investigators at affected universities. Both academic institutions and funding agencies, like the NIH, should provide accommodations for impacted researchers.

Our study has multiple limitations. First, we did not have individual-level data so we could not look at factors such as time of K-award receipt, gender, race, and other variables that could influence productivity of researchers. Furthermore, the CDC COVID-19 Tracker that was used to determine COVID-19 deaths did not distinguish between inpatient and outpatient deaths, which inhibited us from being able to determine the impact of increased clinical work requirements for K-awardees during the pandemic. Additionally, our two groups (states with early peaks vs. late peaks) were of different sizes; therefore, differences in statistical power could have impacted our results. Lastly, our measure of productivity was limited to publications, but this is not the only measure of academic productivity. We were limited by a lack of access to further data such as grants submitted and awarded, which would have strengthened our analysis.

Geographic variability is one piece of the puzzle when assessing the impact of COVID-19 on research productivity, as multiple factors influence academic progress. Casey et al. mention the importance of generational inequality, career stage, personal circumstances, career responsibilities, work environments, places of employment, and related factors [4]. Other studies found gender-based differences in research productivity, noting that female researchers were, on average, less productive than male researchers following COVID-19-related lockdowns [5]. These variables need to be considered to better understand the unequal effect of the pandemic on the academic productivity of K-awardees.

Number of publications per K01, K08, or K23 award funded by the NHLBI from 2015 to 2022 per state stratified by early (2020) vs. late (2021) peak in COVID-19-related deaths per 100,000 residents