Transcutaneous Auricular Vagus Nerve Stimulation (tVNS) can Reverse the Manifestations of the Long-COVID Syndrome

A pilot study

Background: SARS-Cov2 has caused unprecedented morbidity, and mortality across the world. Clinically, acute SARS-Cov2infection ranges from asymptomatic disease to severe pneumonia with respiratory failure, acute kidney and/or cardiac injury.These severe manifestations are induced by hyperinflammation. After the acute phase, a chronic COVID syndrome can occur.Until now, there is no treatment for this chronic syndrome. We first suggested that the syndrome could be due to protractedintensity inflammation. In that way, we decided to test tVNS (transcutaneous Vagal Nerve Stimulation) on the syndromebecause this procedure could reduce inflammatory processes. Methods: 20 patients suffering from chronic COVID syndromewere selected. The symptoms were carefully recorded, and a personal intensity scale was constructed for each patient. Theyreceived 10 daily tVNS stimulations using a Parasym device. Clinical assessments and measures of blood inflammatory factorswere performed on days 0, 5 and 10. The data were analyzed using non-parametric statistical methods. Results: All thepatients completed the study. The clinical manifestations of the disorder were globally similar for each patient: a wax-andwaning syndrome combining fatigue, pain, digestive problems and cognitive difficulties. All the patients improved dramaticallyduring treatment. We did not observe a modification of the blood inflammatory circulating factors, invalidating the hypothesisof an effect of tVNS on a remaining inflammatory state. Conclusions: In this study, we showed that tVNS is an interestingtool for patients with chronic COVID syndrome. Even if this preliminary study did not confirm the hypothesis of protractedinflammation, it helped to propose an alternate explanation, based on the clinical observations supporting COVID-induceddysautonomia. We suggest that tVNS improves chronic COVID syndrome through a “sympathetic reset”.

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