Interview with the project Coordinator, Dr Yvan Devaux
To learn more about the COVIRNA project, we spoke to Dr Yvan Devaux, Coordinator of the project and Head of the Cardiovascular Research Unit at the Luxembourg Institute of Health. Dr Devaux has a background in biological sciences, with over 18 years of experience in cardiovascular disease research and OMICS analyses. His main interest lies in the discovery and validation of novel RNA biomarkers and therapeutic targets of multiple diseases.
He is the founder and chair of the Cardiolinc network (www.cardiolinc.org) initiated in 2014, bringing together complementary expertise from clinicians, basic researchers, statisticians, bioinformaticians, systems biologists, and industrials, towards the satisfaction of unmet medical needs. Dr Devaux is currently chairing the EU-CardioRNA COST Action CA17129 (www.cardiorna.eu), an H2020-funded network of interdisciplinary collaborators throughout 36 EU and international partner countries.
Please tell us a few words about the COVIRNA project and how the idea to establish such a project came up.
Back in October 2018, I obtained funding from the European COST Association to develop a network of investigators from academia, the healthcare sector and the industry. The goal of this network is to allow synergies between experts from different biomedical fields to catalyse the research on the role of RNAs in cardiovascular disease. The network, named CardioRNA currently has more than 200 participants from 36 European and partner countries such as the United States, Canada, Russia, Singapore, Armenia, and South Africa.
In spring 2020, right in the middle of the first lock-down due to COVID-19, the European Commission launched a call for research projects to fight the pandemic. Together with members of the CardioRNA network, we thought that we could apply our skills to develop a tool to aid clinicians to manage the wave of patients infected by the SARS-CoV-2 virus. A group of highly motivated scientists was quickly formed and started to work on a research project, named COVIRNA, to reply to the call of the European Commission.
Since we were all working from home, we started to use communication tools such as Zoom or Webex heavily, and we quickly came up with the idea that a method allowing us to identify patients at risk of developing cardiovascular issues after infection by SARS-CoV-2 would greatly help clinicians to provide the best possible care to patients, depending on their needs.
A significant proportion of patients with COVID-19 develop not only pulmonary problems but also severe cardiovascular problems, such as myocarditis and heart failure. These patients are therefore at high risk and need additional attention. To identify these high-risk patients at an early stage after infection by SARS-CoV-2, we decided to use RNAs naturally present in the blood.
Indeed, in past years, our network acquired a strong expertise in using RNAs circulating in the blood as biomarkers. This means that by measuring the levels of specific RNA molecules circulating in the blood of patients infected by SARS-CoV-2, we can identify patients at risk of developing cardiovascular issues and who should benefit from close attention by healthcare providers.
At this time of project initiation, we still did not know that RNA would shortly become the rising star of novel medical tools and the development of vaccines based on RNA launched a novel area for the use of RNA to fight disease.
What is the added value that the COVIRNA project brings?
The COVIRNA project aims to bring to the market a novel biomedical tool, which in our scientific language we call a molecular diagnostic test since it is based on RNA molecules and provides a diagnosis. This test will allow identifying patients at high risk of developing severe cardiovascular problems. These high-risk patients will consecutively receive dedicated attention, such as monitoring cardiac function, adjusting drugs and so on, to reduce sequelae and avoid fatal issues. Therefore, the test developed during the project will impact healthcare, improve outcomes of patients by reducing morbidity and death rates, improve the life quality of patients, and overall will contribute to reducing the socio-economic burden of COVID-19.
Who are the end-users of the COVIRNA project outcomes and how will they benefit from the project?
The end-users of the test developed during the project are healthcare providers in charge of COVID-19 patients. The test will help clinicians make decisions, adjust healthcare procedures, and maximise efforts for patients with high and specific needs. These patients will see their chances of survival increase and their risk of developing severe sequelae reduced if they can be appropriately taken care of in the hospital. What is important is not only survival but also the quality of life and we believe our test is able to ameliorate both.
Tell us a little bit more about the COVIRNA partners and their expertise.
The COVIRNA project is a spin-off of the pan-European CardioRNA network financed by the European Commission. Scientists, clinicians and industrials from 15 academic research centres, hospitals and private companies working in the biomedical field are involved in the COVIRNA project. They represent 12 different European countries.
The specificity of our consortium relies on its multidisciplinarity. Indeed, experts from a wide range of research fields are involved, ranging from biologists to clinicians, bioinformaticians to biostatisticians, experts in artificial intelligence, healthcare providers, as well as experts in communication and project management. The added value of such a diverse consortium is that it allows complementary and synergistic activities, which are the key to the success of such complex research projects.
What drove you to be part of COVIRNA and what has your experience so far been as the coordinator of such an ambitious project?
COVIRNA is indeed an ambitious project. We had only a couple of months to prepare the entire project since the European Commission expected prompt reactions to their call for research projects, which is absolutely fair and understandable in times of pandemic. However, building such a large consortium and defining the tasks of each partner usually takes 6 to 12 months, but we made it. We have been able to build a consortium and a project very rapidly. The reason for this is that all project partners knew each other and were already collaborating in the context of the CardioRNA consortium. I would like to take this opportunity to thank and congratulate all partners of the project for their quick reaction, right in the middle of the first-ever knock-down we have all suffered.
Independently of the scientific achievement, having been able to develop such an ambitious project so quickly is a great achievement and, as initiator and coordinator of this project, I can only be very proud of my colleagues who are actively participating in the project. Of course, it is highly challenging, time-consuming and stressful to coordinate such an ambitious project, but it is worth it. It is rewarding and extremely valorising, both in terms of scientific achievement as well as personal development. I have already learnt a lot since the initiation of the project, and I still have a lot to learn. Being able to coordinate a large consortium is not an innate thing, it requires a lot of questioning and modesty.
What are the current priorities in the implementation of the project?
The project started in November last year and will last for a total of 2 years. Our current priority is to gather the required number of blood samples from COVID-19 patients and healthy volunteers to be able to measure the RNA biomarkers that will constitute the body of the test that will be developed to identify high-risk patients.
This happened to be more challenging than expected, notably due to slowed down administrative procedures due to the pandemic and difficulties to enrol patients in research projects. Of course, priority is given to taking care of highly ill patients in intensive care units, and clinical studies in the hospitals during the different waves of COVID-19 have been put on a second priority stage. As compensation measures, we developed alternative plans with additional partners to make sure we can secure the required number of patients for the project.
What are the main challenges ahead?
The main challenge ahead will be to complete the project on time, within roughly a year. We still have a lot of work to do but we will do our best to deliver the diagnostic test as soon as possible so that it can be used in the hospital and aid in improving outcomes of COVID-19 patients.
An advantage of the test is that it uses a technology that can be applied to diseases other than SARS-CoV-2 infection. This means that, even if, hopefully, the current COVID-19 pandemic vanishes within the upcoming year, the test will still be applicable, with some modifications, to other medical situations requiring a risk stratification of patients.