Percutaneous Auricular Nerve Stimulation for Treating Post-COVID Fatigue (PAuSing-pCF)

Even mild SARS-CoV-2 infection can lead to post-COVID syndrome, 70% of such patients have post-COVID fatigue (pCF). Many physiological abnormalities observed in pCF could be explained by reduced vagus nerve activity. The vagus nerve, central to metabolic and inflammatory homeostasis, can be activated non-invasively by transcutaneous auricular vagus nerve stimulation (taVNS). Can taVNS improve symptoms in pCF? Data were collected from a randomized study including 114 individuals with pCF. They completed 16 weeks of daily home-based active, sham, or placebo taVNS. Data on subjective fatigue, captured by a Visual Analogue Scale (VAS), and objective measures of cortical excitability, muscle fatigue and autonomic function were collected. In participants meeting minimum adherence (≥1 h/day on ≥50% of days), VAS and peripheral fatigue improved significantly after 8 weeks of active (but not sham or placebo) taVNS (11.9 ± 17.8 points improvement, p=0.003, N=24). These results support taVNS as a potential therapy for pCF.