European Cohorts of Patients and Schools to Advance Response to Epidemics

Project Information

EuCARE

Grant agreement ID: 101046016

DOI

10.3030/101046016

EC signature date 15 November 2021

Start date 14 October 2021

End date 13 October 2026

Funded under

• Health

Total cost

€ 9 995 920,00

EU contribution

€ 9 995 919,50

Coordinated by

EURESIST NETWORK GEIE
Italy

Periodic Reporting for period 3 - EuCARE (European Cohorts of Patients and Schools to Advance Response to Epidemics)

Reporting period: 2024-04-14 to 2025-10-13

Summary of the context and overall objectives of the project

The EuCARE project aims at unveiling the impact of SARS-CoV-2 variants on key sectors of public health. To this end, it gathers a comprehensive multidisciplinary team of clinicians, virologists, epidemiologists, statisticians and top experts in artificial intelligence from strategic areas across 4 continents.
The four project’s cohorts - Hospitalised patients, Post Acute Sequelae of Sars-Cov-2 infection (PASC) patients and Health Care Workers (HCW) and Schools - are the basis of several different observational studies.

The overall aims are:
● To elucidate the relations among different circulating variants, available vaccines and host immune response.
● To analyse the clinical course of COVID-19 in patients in relation to the circulating variants of concern in order to deliver recommendations for optimized clinical management and treatment.
● To deliver recommendations on the best strategies to control viral spread with specific reference to the school setting, in relation to the circulating variants of concern.

To deal with complex interactions among many variables, EuCARE harnesses the power of artificial intelligence.

In the longer-term, EuCARE is committed to maintain active cooperation beyond the duration of the project with a dedicated task in the project.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

Supported by a strong legal, ethical and IT infrastructure, EuCARE set-up four retrospective-prospective cohort studies and one cluster randomised controlled trial.

As of October 13 2025, a total of 49,280 patients have been enrolled in the HOSPITALISED cohort, 2,076 patients have been enrolled in the PASC cohort studying long COVID, 1,725 healthcare workers have been enrolled in the HCW cohort, 437 school classes and 7,886 individuals (students, teachers, non-teaching personnel) have been enrolled in the SCHOOLS cohort and randomised study, and 12,097 biological samples are registered in the EuCARE Virtual Biobank.

Demographic, clinical, laboratory, sequence data as well as answers to the studies questionnaires are collected in the EuCARE centralised data collection platform. Data are standardised according to major standards and available for research studies, under approval procedure and regulatory constraints.

A library of 72 live viral variants is also available on request for scientific studies.

Based on these assets, the project has contributed to the elucidation of COVID-19 and SARS-COV-2 variants impacts on several aspects, from clinical outcome, including long term, to the psychological impact of containment measures in schools, with 65 peer reviewed publications.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

Our study on in-hospital mortality in relation to viral variants shows that in-hospital mortality rates decreased over the course of the pandemic, particularly since the emergence of the Omicron variant. This is suggested to reflect a combined effect of immunity from vaccinations and previous infections, although it cannot be excluded that differences in virulence between SARS-CoV-2 variants may have contributed too.
Also, our studies on co-infections and on use of antivirals show increased co-infecion rates with new variants and call for sustained monitoring and clinical vigilance of co-infections and prioritization of nonimmune individuals for antiviral treatment.

Our study on post-COVID condition (PCC) shows a lower risk of PCC with Omicron variant vs wild type (WT), and a higher PCC risk with Alpha and Delta variant vs WT. However, the WT effect vs Omicron on PCC risk appeared to be mediated by intensive care unit admission. Thus, the observed reduction of the PCC-burden over time may be partly due to a reduced risk of acute severe disease associated with Omicron infections in patients with immunity or prior infections.

Our study on data from Italy, Germany and Portugal in autumn 2022, when the Omicron variant was prevalent and limited preventive measures were implemented in schools, found no evidence of a causal relationship between school reopening in autumn 2022 and Omicron SARS-CoV-2 transmission, with lower case reproduction number (Rc) (Italy and Germany) or Rc decreasing trend (Portugal) associated with school opening.

Our studies in schools assessed the Lolli Methode as an important method for containing the epidemic in schools, in particular for teachers and high school students, and as a valuable surveillance method, that it is well accepted and implementable in different geographical and socio-economic environments. They also confirm the significant impact of preventive measures on students’ mental health, with Distant Learning playing a particularly detrimental role. Girls reported a worse experience with Distant Learning, resulting in greater psychological difficulties compared to boys.

Our evaluation of 12 diagnostic platforms showed that all of them successfully identified Alpha, Beta, Gamma, Delta and Omicron (B.1.1.519) variants, without false positive results.

EuCARE_SchoolPilot_Lodi

EuCARE Project Structure

Samples collected

EuACRE Consrtium Map

Enrolment in SCHOOLS studies

EuCARE Database Structure

Enrolment in clinical studies