[Article series] The experts behind Luxembourg’s Covid-19 fight

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• Transversale Translationale Medizin (TTM)

Interview with Prof Rejko Krüger

Prof Rejko Krüger (RK) is the Director of Transversal Translational Medicine (TTM) at LIH. As a medical doctor and researcher, he is an internationally recognised “clinician scientist”, expert in both the clinical and research sides of neurodegenerative diseases, as well as in the development of translational cohort studies. In the context of the COVID-19 pandemic, Prof Krüger and his team are currently involved in the coordination of the CON-VINCE study. In this short interview, he explains his expertise and participation in ongoing COVID-19 projects.

Prof Krüger, could you tell us more about your background and expertise?

RK: I am both a neurologist, specialised in movement disorders and neurodegeneration, and a neuroscientist. As such, I play a dual role in the healthcare and biomedical research sectors. Indeed, on the one hand, I exert my medical profession at the Neurology Department of the Centre Hospitalier de Luxembourg (CHL), where I carry out patient consultations. On the other, I am involved in fundamental and clinical research across the key research institutes in Luxembourg. Indeed, I hold concomitant positions at the University of Luxembourg as Professor of Neuroscience, I supervise a clinical and experimental research group on Parkinson’s disease at the Luxembourg Centre for Biomedicine Systems (LCSB) at the University of Luxembourg and, as of June 2019, I joined LIH as Director of the newly created Transversal Translational Medicine (TTM). Through these positions, my priority is to create a ‘bridge’ between fundamental and clinical research, bringing together all the stakeholders involved in healthcare provision to achieve what is known as integrated care, that is a patient-centric approach based on the concerted functioning of all concerned parties at the funding, administrative, organisational, service delivery and clinical levels.

How is your expertise relevant in the current COVID-19 context?

RK: As the coordinator of the National Centre of Excellence in Research on Parkinson’s disease (NCER-PD) — Luxembourg’s flagship translational programme on neurodegeneration — and Director of TTM, I have acquired a strong expertise in the conception and implementation of translational cohort studies. Specifically, my team and I are working towards the translation of the “template” developed for neurodegenerative disorders under NCER-PD to other disease areas, such as cancer and immunity. This experience has proved to be crucial in the current COVID-19 situation. Indeed, in the context of the ongoing CON-VINCE study, we were able to establish a cohort of over 1,800 individuals representative of the Luxembourg population in just three weeks. As a reference, it took four years to recruit the 1,600 volunteers for NCER-PD – of course with a different design always adapted to the specific conditions. My extensive network and deep knowledge of the Luxembourg biomedical ecosystem and its players have also proved to be essential in this respect.

What is your specific role in the ongoing COVID-19 initiatives of the Research Luxembourg taskforce?

RK: I am currently active on many fronts in the fight against COVID-19. My main role is to coordinate the CON-VINCE study, which aims to identify asymptomatic individuals to assess the spread of the disease in Luxembourg. The main challenge we encountered was to decide on the approach to be adopted to set up and recruit a cohort of people representative of the Luxembourg population in such a short timeframe. We therefore decided to collaborate with the market research company TNS-ILRES since they already had a representative cohort ready. This helped us speed up the process and get the study up and running very quickly. In addition, I am also involved across many of the other work packages of the Research Luxembourg taskforce, since these initiatives are all interconnected with each other. For instance, I am contributing to the Predi-COVID study by referring participants from the CON-VINCE cohort who have tested positive for the SARS CoV-2 virus and have COVID-19 symptoms to the team in charge of Predi-COVID, in order to help them build up the cohort of COVID-positive patients. Similarly, I am collaborating on the work package on the implementation of eHealth solutions for hospitalised and ambulatory patients, since CON-VINCE will rely on the development and use of an application to monitor participants and collect their data. Finally, we are also collaborating with the work package aiming to increase Luxembourg’s diagnostic capacity and large-scale testing.

Could you tell us more about your internal and external collaborators and their roles?

RK: The complexity of these projects requires a particularly strong teamwork and collaboration with numerous partners, both internal and external. Indeed, each task is marked by the close interaction between colleagues within and outside LIH. For instance, the sample collection and logistics aspect of the CON-VINCE study relied heavily on the joint work of various partner laboratories in Luxembourg, namely Ketterthill, Laboratoires Réunis and BioneXt Lab, and the Integrated Biobank of Luxembourg (IBBL). The laboratories are in charge of sample collection from participants, while IBBL plays the crucial role of preparing the collection kits, carrying out quality control tests on the samples and overseeing the overall logistics. Moreover, the commitment of many volunteers and staff members from LIH, as well as from the University of Luxembourg, the Luxembourg Centre of Systems Biomedicine (LCSB), the Laboratoire National de Santé (LNS) and CHL, is essential in enabling the smooth running of the project. The NCER-PD and Parkinson Clinic teams were also mobilised to contribute to the study. I would also like to specifically mention the remarkable work of the CON-VINCE project management team, including Clarissa Gomes, who manages both NCER-PD and CON-VINCE, Joelle Fritz, our research and strategy specialist responsible for stakeholder relations management, as well as Bianca Dragomir and Tania Zamboni, who are in charge of handling the queries received through the CON-VINCE mailbox and dedicated hotline. Similarly, our multi-disciplinary team encompasses other specialised profiles, including nurses doing a PhD, such as Anne-Marie Hanff. Finally, I am also in close contact with Markus Ollert, Director of the LIH Department of Infection and Immunity (DII), in the context of the diagnostic capacity and large-scale testing work package, as well as with Laetitia Huiart, Director of the LIH Department of Population Health (DoPH), and Manon Gantenbein, Head of the Clinical and Epidemiological Investigation Center (CIEC) at DoPH, in the framework of our collaboration on the Predi-COVID study. This public health situation has further stressed the importance of effective cooperation in achieving meaningful scientific results with concrete health benefits for our patients.