Bologna, 22 Dicembre 2022
(Long) COVID, vaccination efficacy and immune response:
European research project ORCHESTRA finds answers – in broad collaboration
The SARS-CoV-2 pandemic has challenged public health worldwide - and brought enormous suffering. The European project ORCHESTRA - Connecting European Cohorts to Increase Common and Effective Response to SARS-CoV-2 Pandemic - was launched in December 2020 to unite European knowledge and resources to find medical answers to the most pressing questions of the crisis. With 37 partners from 15 countries working closely together, ORCHESTRA has evolved into a sustainable multinational network. Treatment and prevention measures of COVID-19 and Long COVID, vaccination efficacy and immune response are the main research areas of the project. First results and next steps have been discussed at the annual conference at the Palazzo Verità-Poeta in Verona on 21 and 22 November. More than 150 researchers and experts from all over Europe and beyond, as well as representatives from the European Commission (EC), the European Centre for the Prevention and Control of Communicable Diseases (ECDC) and the European Medicines Agency (EMA) attended the Partner Meeting.
Led and initiated by Prof. Evelina Tacconelli (director of the Infectious Diseases section at the University of Verona) and her team, ORCHESTRA is part of HORIZON2020, the EU innovation and funding programme, and started with the goal to create a clear understanding of the clinical expression of the SARS-CoV-2-Pandemic - and to deliver recommendations for future health crises (e.g. on the topic of data sharing Challenges of data sharing in European Covid-19 projects: A learning opportunity for advancing pandemic preparedness and response - ScienceDirect.
ORCHESTRA, as a large-scale cohort research project, unites patient data from the participating partners. Cohort research means that certain groups of patients are followed from one defined time point to another. Observing long-term symptoms of the disease has been a goal from the beginning of the project on, long before the term “Long COVID” was known - let alone its societal impact. "The ORCHESTRA project" - underlines Tacconelli - "now includes, after 2 years from the beginning of the work, more than 60 historical and prospective cohorts for a total of more than one million individuals from 15 countries. Thanks to the work and collaboration of numerous working groups, we are now able to better understand the meaning of Long COVID, which is not a single disease but unfortunately consists of several diseases.” ORCHESTRA research found that women are more at risk than men and neurological symptoms, such as headache, can be early indicators of consequences even after recovery. The research in ORCHESTRA continues – many aspects of the disease are still uncovered.
ORCHESTRA’s has a strong focus on researching the immunological aspects of SARS-CoV-2 infections and several important findings have been made. One of them is that previous infections seem to play an important role in determining the level of antibodies. Another finding is that immunological responses impact SARS-CoV-2 mutations – antiviral medication can even cause Spike mutations of the virus. Understanding the immune responses in antibodies to SARS-CoV-2 have the potential to improve vaccination efficacy and in particular to better protect the fragile population.
ORCHESTRA embodies the European values of collaboration: The annual partner meeting confirmed once again the exponential impact of strong joint efforts. On the one hand, ORCHESTRA is producing rigorous scientific evidence with all the publications based on ORCHESTRA data – more are yet to come (Publications - ORCHESTRA Cohort (orchestra-cohort.eu)), for a better understanding and handling of the disease. On the other hand, ORCHESTRA contributes to an international effort to strive towards interoperability of studies and between health care professionals. This requires continuous efforts to perform the transformation to harmonised data, protocols and workflows. In terms of data harmonisation and standardisation, ORCHESTRA has achieved a strong foundation (Harmonization and standardization of data for a pan-European cohort on SARS- CoV-2 pandemic | npj Digital Medicine (nature.com)). "Throughout the various studies of the project, different case report forms can include the same concepts but expressed in different ways. For example “Fever” could be described as temperature, elevated temperature or high temperature, which does not allow a computer to recognize if it is the same concept. It is very important to use international semantic standards to allow also machines to unambiguously identify clinical concepts thus facilitating the merging of data from different sources”, says Eugenia Rinaldi from ORCHESTRA partner BIH_Health Charité. Her colleague, Caroline Stellmach explains how the team also had to define new concepts in coding variables: “Many aspects of the SARS-CoV-2 infection were still widely unknown at the beginning of the project. New variables describing specific tests, such as the genomics of the virus or sociopolitical concepts, such as lockdown measures had not yet been defined.” The team mapped more than 2,500 variables and submitted more than 100 new concepts for coding to the international Standards Developing Organizations (SDOs) SNOMED CT, LOINC, and NCI. The newly created codes are all openly available to the international research community for use in other projects.
ORCHESTRA is based on a fair and transparent collaboration. An advisory board monitors the progress and advises the multinational team. Catherine Cohet, PhD, is a member of the ORCHESTRA Advisory Panel, and attended the Partner Meeting as a representative of the European Medicines Agency (EMA). She describes her impression of ORCHESTRA: “I have been observing the project since its inception attending the different meetings. Every time, I am impressed by the achievements of and the collaborative efforts and how the work has been adapting to the needs of the different phases of the disease. I see the outputs and learnings from ORCHESTRA having a great impact on pandemic preparedness for future diseases.”
CINECA is a partner of ORCHESTRA and supports the international efforts to collaborate in the search for treatment and prevention measures against SARS-CoV-2. For further information, please visit www.orchestra-cohort.eu
