Five Years After COVID-19, Halfway Through NeuroCOV: Joachim Schultze on NeuroCOVID, Pandemic Preparedness, and Lessons for the Future

On March 11, 2020, the WHO declared COVID-19 a pandemic, giving the world a term for what was unfolding—yet leaving countless uncertainties in communities, countries, and lives across the globe. Five years later, many questions remain: Is it truly over? If so, for whom? Who has been left behind? And what lessons are we carrying forward as a society from those unsettling first months of 2020?

To explore these questions, we spoke with our coordinator, Joachim Schultze, who is Professor and Head of Genomics & Immunoregulation at the University of Bonn and Head of the Platform for Single Cell Genomics and Epigenomics at the DZNE.

Prof. Schultze, five years ago, the WHO declared COVID-19 a pandemic, and two and a half years ago, you launched the NeuroCOV project. Now, while the pandemic is widely considered over, the project still has more than 30 months to go. Does this mean the topic is no longer relevant, or does scientific research inherently take longer than we, as citizens, had hoped back in 2020?

Our project remains highly relevant as COVID-19's long-term effects, such as Long COVID and neurological issues, continue to have a significant impact on global health. Of course, scientific research takes time for thorough investigation, replication, and peer review—often exceeding public expectations. However, the complexity of studying neurological impacts justifies the extended timeline.

Looking back, what have we learned about science communication and public engagement during the pandemic? What approaches were effective, and where did we fall short?

On a positive note, we had the chance to implement effective strategies through the collaboration between scientists and communicators, building trust with consistent messaging from health organizations. The spread of misinformation and information overload, leading to public fatigue, both highlight areas for improvement in future crises.

What are the key challenges in NeuroCOVID research?

As often observed for neurological disorders, the varying severity and manifestations of chronic NeuroCOVID across individuals complicates the identification of consistent molecular patterns. Despite advances in the past two years, determining whether neurological issues stem from direct viral effects, immune response, or other factors remains challenging, emphasizing the need for sustained, interdisciplinary efforts. Another key aspect that needs further elucidation is the clinical and molecular overlap between COVID-19-related long-term neurological sequelae and similar conditions, such as ME/CFS and neurodegenerative disorders.

Did the rollout of COVID-19 vaccines influence the overall approach of the NeuroCOV project? Did you have to adjust your clinical research, and if so, how?

The introduction of vaccines altered the virus's trajectory, leading to changes in symptom profiles and potentially reducing the number of severe cases that contribute to neurological issues. In NeuroCOV, we are incorporating infection and vaccination status into our data analysis to monitor potential clinical sub-stratification in the analysed population.

NeuroCOV aims to develop treatments for people experiencing neurological and neuropsychiatric complications due to COVID-19. Can you share any insights from the project’s findings so far?

We set up two important clinical studies in Italy and Germany, and we are more than halfway through the recruitment process, aligned with our target cohort size. We are now primarily focused on generating data spanning genotyping, multi-omics of peripheral immune cell profiles, and plasma proteomics to potentially identify biomarkers. This data will soon be available for more than 300 individuals, with the dataset expected to double by the end of the year. Preliminary data point to molecular patterns already observed in the blood of affected individuals, helping us further stratify donors alongside results from our donor-derived brain organoid models. However, we’ll need to further validate and expand our findings in the coming months.

The NeuroCOV project also explores the short- and long-term economic consequences of COVID-19 and related control measures, recognising that the same virus affects people differently depending on their economic circumstances. How crucial is it to address economic inequalities to improve public health? What have we learned as a society in this regard?

Economic inequalities can significantly influence access to healthcare, nutrition, housing, and other determinants of health. The COVID-19 pandemic has starkly highlighted how socioeconomic disparities worsen health outcomes, with marginalized groups facing higher infection rates, more severe health complications, and limited access to recovery resources. As a society, we’ve learned that reducing inequalities is essential for building resilient populations capable of withstanding public health crises. Policies like universal healthcare, social safety nets, and equitable resource distribution play a crucial role in this process. By prioritizing economic equity, we can create healthier societies better prepared to address future challenges.

If you could offer one piece of advice to policymakers preparing for future pandemics, what would it be? And what advice would you give to the scientific community?

To policymakers, my advice is to prioritize the development of robust, equitable research and healthcare infrastructure and ensure global collaboration on early detection and response systems. Invest in pandemic preparedness now to avoid catastrophic impacts in the future. To the scientific community, focus on addressing knowledge gaps, fostering open communication, and promoting interdisciplinary collaboration to swiftly inform evidence-based policies.