Periodic Reporting for period 3 - ORCHESTRA (Connecting European Cohorts to Increase Common and Effective Response to SARS-CoV-2 Pandemic: ORCHESTRA)
Reporting period: 2023-12-01 to 2024-11-30
The COVID-19 pandemic urgently demanded innovative, rapid, and evidence-based solutions to control the pandemic, optimize COVID-19 treatment, and understand the long-term health consequences. The rapid rollout of vaccines, the emergence of new variants, and the introduction of preventive and therapeutic measures highlighted the critical need for a research infrastructure capable of adapting to the evolving epidemiological landscape. This infrastructure needed to be flexible enough to capture and respond to constantly emerging evidence regarding therapeutic responses, clinical outcomes, vaccine responses, long-term sequelae, and social and economic impacts.
The ORCHESTRA project aimed to address this need by creating a pan-European cohort encompassing the general population, COVID-19 patients, vulnerable individuals, and healthcare workers. Utilizing harmonized data collection, sharing, and sampling protocols, ORCHESTRA sought to provide evidence-based recommendations for managing the SARS-CoV-2 pandemic and contribute to preparedness for future public health threats.
The ORCHESTRA project aimed to address this need by creating a pan-European cohort encompassing the general population, COVID-19 patients, vulnerable individuals, and healthcare workers. Utilizing harmonized data collection, sharing, and sampling protocols, ORCHESTRA sought to provide evidence-based recommendations for managing the SARS-CoV-2 pandemic and contribute to preparedness for future public health threats.
ORCHESTRA built a large research network involving over 85 observational studies (cohorts). These cohorts focused on various groups of people, including those with COVID-19 and long-term effects, the general population, people with existing health conditions, and healthcare workers. In total, the project enrolled 529 000 participants directly (broken down as 7600 in the COVID-19/post-COVID-19 group, 448 917 in general population studies, 9237 in studies of vulnerable populations, and 63 516 healthcare workers) and also incorporated data from existing health records of another 2 350 000 people.
A key achievement was the ORCHESTRA Data Portal, a user-friendly online platform that allows researchers to share and reuse data securely. This platform uses advanced techniques like federated learning, which allows researchers to analyse data without moving it from its original location, and also provides tools for exporting data for specific research questions. ORCHESTRA also created a common "language" for describing health information, defining over 3700 standardized data points and creating 210 new codes for things like social and economic factors, psychological well-being, and lifestyle. This standardized "language," which includes information about Post-COVID-19 Condition (PCC), was used to create a standard electronic form for future research studies on long-term effects of infections.
ORCHESTRA's research has helped us better understand PCC, including how symptoms change over time. Studies looking at changes in DNA patterns suggested a possible biological explanation for PCC, showing that some changes can persist for months after the initial infection. The project also developed practical guidelines for doctors treating COVID-19 patients with pre-existing health conditions. These guidelines cover topics like assessing risk, prevention, vaccination, diagnosis, managing other health problems, early treatment, and PCC. A new tool was also developed to help screen healthcare workers for emotional exhaustion during public health crises.
Analyses of gut bacteria provided insights into how COVID-19 progresses, showing that the diversity and makeup of gut bacteria could potentially be used as an early indicator of how someone will fare with the disease. ORCHESTRA also studied the broader impact of COVID-19 on society, including social and economic consequences, disruptions to healthcare, changes in retirement patterns, how the virus spread in communities, and how different countries responded to the pandemic, especially in lower- and middle-income countries.
ORCHESTRA has published 125 scientific articles in peer-reviewed journals (with an average impact factor of 5.6 and over 370 citations).
A key achievement was the ORCHESTRA Data Portal, a user-friendly online platform that allows researchers to share and reuse data securely. This platform uses advanced techniques like federated learning, which allows researchers to analyse data without moving it from its original location, and also provides tools for exporting data for specific research questions. ORCHESTRA also created a common "language" for describing health information, defining over 3700 standardized data points and creating 210 new codes for things like social and economic factors, psychological well-being, and lifestyle. This standardized "language," which includes information about Post-COVID-19 Condition (PCC), was used to create a standard electronic form for future research studies on long-term effects of infections.
ORCHESTRA's research has helped us better understand PCC, including how symptoms change over time. Studies looking at changes in DNA patterns suggested a possible biological explanation for PCC, showing that some changes can persist for months after the initial infection. The project also developed practical guidelines for doctors treating COVID-19 patients with pre-existing health conditions. These guidelines cover topics like assessing risk, prevention, vaccination, diagnosis, managing other health problems, early treatment, and PCC. A new tool was also developed to help screen healthcare workers for emotional exhaustion during public health crises.
Analyses of gut bacteria provided insights into how COVID-19 progresses, showing that the diversity and makeup of gut bacteria could potentially be used as an early indicator of how someone will fare with the disease. ORCHESTRA also studied the broader impact of COVID-19 on society, including social and economic consequences, disruptions to healthcare, changes in retirement patterns, how the virus spread in communities, and how different countries responded to the pandemic, especially in lower- and middle-income countries.
ORCHESTRA has published 125 scientific articles in peer-reviewed journals (with an average impact factor of 5.6 and over 370 citations).
The ORCHESTRA project built a large, Europe-wide network of research studies, called a "cohort," made up of many smaller, specialized studies. This network, with its diverse groups of participants, and the shared tools developed for collecting and analysing data, is a major step forward in research. It makes it much easier to gather the evidence needed to create effective public health programs and improve clinical care. The ORCHESTRA Data Portal will keep this valuable data accessible to researchers even after the project ends, allowing them to continue studying it through data sharing and advanced analysis techniques.
ORCHESTRA also used innovative approaches in its research, including sophisticated statistical methods (like latent class analysis and the Bass diffusion model), new questionnaires, and a simple blood testing method called dried blood spot testing. These advances are expected to lead to better-quality research studies in the future.
ORCHESTRA's findings have already led to improvements in how COVID-19 is managed and treated, especially for people with long-term effects (PCC). This includes creating tailored guidelines for vulnerable populations. The project's comprehensive approach to studying PCC—using cutting-edge techniques to examine changes in genes, gut bacteria, the immune system, and inflammatory markers—shows how important it is to look at multiple factors when studying long-term effects of infections. Additionally, the project’s insights into the social, economic, and behavioral impacts of COVID-19 are essential for planning for future pandemics. This includes addressing critical issues like burnout among healthcare workers and the effects of lockdowns on mental health.
ORCHESTRA's influence is also clear in its outreach and communication efforts, particularly its leadership in the Cohort Coordination Board. This group brings together researchers from similar studies across Europe to share knowledge, avoid repeating work, find areas for collaboration, and advise the European Commission on important research priorities.
ORCHESTRA also used innovative approaches in its research, including sophisticated statistical methods (like latent class analysis and the Bass diffusion model), new questionnaires, and a simple blood testing method called dried blood spot testing. These advances are expected to lead to better-quality research studies in the future.
ORCHESTRA's findings have already led to improvements in how COVID-19 is managed and treated, especially for people with long-term effects (PCC). This includes creating tailored guidelines for vulnerable populations. The project's comprehensive approach to studying PCC—using cutting-edge techniques to examine changes in genes, gut bacteria, the immune system, and inflammatory markers—shows how important it is to look at multiple factors when studying long-term effects of infections. Additionally, the project’s insights into the social, economic, and behavioral impacts of COVID-19 are essential for planning for future pandemics. This includes addressing critical issues like burnout among healthcare workers and the effects of lockdowns on mental health.
ORCHESTRA's influence is also clear in its outreach and communication efforts, particularly its leadership in the Cohort Coordination Board. This group brings together researchers from similar studies across Europe to share knowledge, avoid repeating work, find areas for collaboration, and advise the European Commission on important research priorities.