(Long) COVID, vaccination efficacy and immune response: Answers presented at ORCHESTRA Partner Meeting in Verona
The Partners Meeting in Verona, Palazzo Verità-Poet,a on 21 and 22 November 2022 was a wonderful opportunity to discuss first results of the project and to meet for the first time in person. 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.
Observing long-term symptoms of the disease has been a goal from the beginning of the project on. “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 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.”