Prof. Dr. Thomas Illig and Univ.-Prof. Dr. Jörg Janne Vehreschild

LEOSS: interview with Thomas Illig and Janne Vehreschild

The LEOSS register documents the clinical data of patients infected with SARS-CoV-2. LEOSS stands for “Lean European Open Survey for SARS-CoV-2 Infected Patients” and thus for a European model for free, anonymous data storage. All of the data collected is available to the scientific community for collaborative analyses. LEOSS was developed on the initiative of the German Society of Infectious Diseases (DGI) and the German Center for Infection Research (DZIF). Coordinator Prof. Dr. Jörg Janne Vehreschild, a DZIF scientist at the University Hospital Cologne, is now working to expand the survey into a Germany-wide cohort study. Vehreschild and Prof. Dr. Thomas Illig, who is deputy head of the German Biobank Node (GBN) and responsible for biobanking for the LEOSS initiative, discuss their plans in an interview.

How did the LEOSS register come about?

Janne Vehreschild: My team and I wanted to create an alternative to the extremely detailed WHO questionnaire on the time that Covid-19 patients spend in intensive care. A more compact questionnaire that at the same time caters more to the European population. We have added detailed questions on comorbidity and the early stages of the virus to identify the characteristics that lead to a stay in intensive care even being necessary. This is how the “Lean European Open Survey” came about. Various clinics have contributed information on almost 2,500 patients since the beginning of March.

What is now the next step?

Vehreschild: On the initiative of the DZIF and together with the other German Centres for Health Research (DZG) and several biobanks, a professional cohort is to now be developed. We have created “LEOSS.core” for the clinical, epidemiological data from the original LEOSS register and additionally introduced “LEOSS.deep” to link the epidemiology with the biosamples. We are not so “lean” anymore, but rather quite substantial and instead known as a “Longitudinal European Open Study”. We submitted a funding application for this study at the end of April.

What are you planning for the next project phase?

Thomas Illig: Within three years, we want to include 20,000 people across Germany in our study. We will collect biosamples from 10,000 of them and just data from the other 10,000. We will include both Covid-19 patients and a control group. The patients should include people suffering from the virus in various degrees of severity as well as all ages and genders. We will see these patients up to four times, when they are in hospital and again when they are healthy again. For the control group, we are ideally looking for people with respiratory tract infections, who tested negative for SARS-CoV-2. Based on this information, we aim to define clinical phases according to the severity of the symptoms. We want to ascertain why one person becomes seriously ill and another does not even realise they are infected. Why some patients must be put on a ventilator and some even die. We are also interested in the long-term effects.

Vehreschild: LEOSS will also allow us to determine how effective medical interventions are. At the same time, we can develop hypotheses for basic research: what are meaningful targets, which approaches should we pursue? In terms of clinical research, our aim is to conduct feasibility studies. These will allow us to advise on study planning or even to identify “suitable” patients for certain studies.

Which institutions and initiatives are you cooperating with?

Illig: First off, we have been able to get all DZG on board for LEOSS; we’re very pleased about this. For me personally, the involvement of the German Biobank Node and German Biobank Alliance is also particularly good news. GBA biobanks can at the same time be found at many DZG sites. We have created important structures within GBN/GBA for high-quality biobanking, harmonising the standard operating procedures (SOPs) and practices at the various biobanks. Samples of comparable quality are especially important when it comes to molecular questions. That’s why a standardised biosample programme is so important for LEOSS. It would of course be great if our initiative could now rapidly be granted funding.

Vehreschild: We also work closely with the Medical Informatics Initiative (MII) and the national Covid-19 research network. The DeCOI group plays a role, too: the leading experts in the field of omics have joined forces and are planning to sequence sample material from LEOSS participants. We cooperate with a whole host of professional associations and work on analyses and additional questionnaires – with the German societies for haematology and oncology, cardiology, neurology and paediatric infectiology, for example. The fact that we cooperate so closely with countless professional associations and build on successful infrastructures such as the DZG and GBN/GBA is one of the project’s greatest strengths.

What types of biosamples do you want to collect?

Illig: In order to obtain plasma and isolate DNA, we are collecting EDTA blood first. This is important for genetic and post-genetic investigations. Since clotting factors seem to play a role in Covid-19, we are also collecting citrated plasma, in which it is possible to investigate this particularly well. For functional approaches, we have included living cells in the programme and to enable transcriptome analyses, we have decided on PAXgene tubes, which enable the highly standardised storage of RNA. We also take swabs from either the nose or throat. Sputum and bronchoalveolar lavage (BAL) are possible, too. We collect urine as well because there are many indications that the kidneys of intensive care patients suffer immensely.

Who can access the LEOSS samples and data?

Illig: Clear rules are of course necessary for researchers to be able to access samples and data. We shall therefore appoint Use & Access committees as soon as possible. For sites contributing samples and data, there should also be a veto right for research proposals. In principle, though, the samples and data are accessible to all scientists around the globe.

The interview was conducted by Verena Huth.

Visit the LEOSS website

 

Questions?

germanbiobanknode@charite.de

Tel. +49. 30. 450 536 347


Fax +49. 30. 450 753 69 38

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